Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02968 | Date 11/01/2019 |
| Token No | SM/21-22/2399 21/06/2021 | Serial | 042 Last Visit: 21/06/2021 |
| Patient Name | Mrs. RENUKA PAL | Contact No | 7044953064 |
| Address | 1 A.P GHOSH ROAD | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||