Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09555 | Date 30/04/2021 |
| Token No | SM/21-22/2082 09/06/2021 | Serial | 047 Last Visit: 09/06/2021 |
| Patient Name | Mrs. KALPANA RAY | Contact No | 8420014923 |
| Address | BARABAGAN SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||