Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10796 | Date 14/03/2022 |
| Token No | SM/21-22/10753 14/03/2022 | Serial | 012 Last Visit: 14/03/2022 |
| Patient Name | Miss SAMPARNA DAS | Contact No | 9748347547 |
| Address | 69/2/1 G.T ROAD WEST SERAMPORE (M) MALLICKPARA HOOGHLY | Age | 10+ YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||