Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09319 | Date 15/03/2021 |
| Token No | SM/21-22/2417 22/06/2021 | Serial | 006 Last Visit: 22/12/2021 |
| Patient Name | Mrs. MANASI GHOSH | Contact No | 8017627166 |
| Address | 18/E K.K. MUKHERJEE SARANI, | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||