Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09157 | Date 11/01/2021 |
| Token No | SM/20-21/29740 25/01/2021 | Serial | 024 Last Visit: 25/01/2021 |
| Patient Name | Mrs. DURGABATI SHA GUPTA | Contact No | 9831868580 |
| Address | 10 L B S ROAD SERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||