Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03008 | Date 15/01/2019 |
| Token No | SM/20-21/30927 19/03/2021 | Serial | 036 Last Visit: 19/03/2021 |
| Patient Name | Mrs. SWAPNA DAS | Contact No | 9804922977 |
| Address | BAHIR SERAMPORE, KALITALA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||