Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09365 | Date 19/03/2021 |
| Token No | SM/20-21/30954 19/03/2021 | Serial | 063 Last Visit: 26/03/2021 |
| Patient Name | Mrs. PUTUL SHAW | Contact No | |
| Address | K.M.BHATTACHARJEE STREET 51 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||