Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 09647 | Date 24/05/2021 |
| Token No | SM/21-22/1680 24/05/2021 | Serial | 058 Last Visit: 24/05/2021 |
| Patient Name | Mrs. NILAM SHA | Contact No | 9903190090 |
| Address | 28,BAZAR BYE LANE SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||