Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09670 | Date 03/06/2021 |
| Token No | SM/21-22/2261 14/06/2021 | Serial | 053 Last Visit: 14/07/2021 |
| Patient Name | Mrs. RITA ROUTH | Contact No | 9007079719 |
| Address | CHATRA MUSHALMAN PARA SERAMPORE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||