Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09584 | Date 05/05/2021 |
| Token No | SM/21-22/1156 05/05/2021 | Serial | 015 Last Visit: 05/05/2021 |
| Patient Name | Miss LATA KOLEY | Contact No | 8013607892 |
| Address | BOUBAZAR CHATRA SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||