Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09632 | Date 21/05/2021 |
| Token No | SM/21-22/1608 21/05/2021 | Serial | 024 Last Visit: 17/06/2021 |
| Patient Name | Mrs. GITA CHOWDHURY | Contact No | 9051186019 |
| Address | 4,DOCTOR BAGAN LANE SERAMPORE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||