Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09724 | Date 15/06/2021 |
| Token No | SM/21-22/2412 22/06/2021 | Serial | 001 Last Visit: 22/06/2021 |
| Patient Name | Mrs. RAMA DAS | Contact No | 8420866176 |
| Address | 1 NO.SERAMPORE COLONY DAKSHIN RAJYADHARPUR | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||