Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02097 | Date 22/11/2018 |
| Token No | SM/21-22/109 05/04/2021 | Serial | 022 Last Visit: 12/11/2021 |
| Patient Name | Mrs. RAFIKA BEGAM | Contact No | 8926679534 |
| Address | CHATRA MUSALMAN PARA, SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||