Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09736 | Date 22/06/2021 |
| Token No | SM/21-22/2436 22/06/2021 | Serial | 025 Last Visit: 09/02/2022 |
| Patient Name | Mrs. REKHARANI DAS | Contact No | |
| Address | 99,N.S AVENUE SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||