Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09015 | Date 01/12/2020 |
| Token No | SM/21-22/1846 01/06/2021 | Serial | 023 Last Visit: 01/06/2021 |
| Patient Name | Miss LISA DAS | Contact No | 8013156326 |
| Address | 80 RISHI BANKIM SARANI SERAMPORE | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||