Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00735 | Date 27/08/2018 |
| Token No | SM/20-21/29565 20/01/2021 | Serial | 013 Last Visit: 20/01/2021 |
| Patient Name | Mrs. KALPANA BAG | Contact No | 8910046340 |
| Address | 203/D GHOSAL PARA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||