Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09733 | Date 22/06/2021 |
| Token No | SM/21-22/2422 22/06/2021 | Serial | 011 Last Visit: 26/07/2021 |
| Patient Name | Mrs. UMA RANI MITRA | Contact No | 7980446042 |
| Address | 150/A RAMKRISHNA ROAD CHATRA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||