Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00267 | Date 09/08/2018 |
| Token No | SM/20-21/31064 23/03/2021 | Serial | 001 Last Visit: 31/05/2021 |
| Patient Name | Mrs. RENUKA MONDAL | Contact No | 8583907269 |
| Address | 32, CHAKRABORTY LANE , SERAMPORE | Age | 50 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||