Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09339 | Date 17/03/2021 |
| Token No | SM/20-21/30849 17/03/2021 | Serial | 028 Last Visit: 10/11/2022 |
| Patient Name | Mrs. SHEFALI CHATTOPADHAY | Contact No | 9903864889 |
| Address | 53DR, G.C. GOSWAMI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||