Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09154 | Date 11/01/2021 |
| Token No | SM/20-21/29393 15/01/2021 | Serial | 026 Last Visit: 15/01/2021 |
| Patient Name | Mrs. JHARNA PAL | Contact No | 9903368934 |
| Address | 5 KUMARPARA LANE SERAMPORE M | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||