Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09412 | Date 31/03/2021 |
| Token No | SM/20-21/31329 31/03/2021 | Serial | 013 Last Visit: 31/03/2021 |
| Patient Name | Mrs. TUMPA GHOSHAL | Contact No | 8420123105 |
| Address | 206/55 VIVEKANANDA SARANI NABA GRAM MALLICK PARA SERAMPORE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||