Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09621 | Date 18/05/2021 |
| Token No | SM/21-22/1520 18/05/2021 | Serial | 040 Last Visit: 18/05/2021 |
| Patient Name | Mrs. KALPANA MAJHI | Contact No | 9830162563 |
| Address | 62/A BYE SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||