Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08902 | Date 21/10/2020 |
| Token No | SM/20-21/30222 01/03/2021 | Serial | 042 Last Visit: 01/03/2021 |
| Patient Name | Mrs. ARPITA KUMARI SHAW | Contact No | 9681465667 |
| Address | 57/J/E G.T. ROAD,PAMPANAGAR ,BAIDYABATI(M) | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||