Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09751 | Date 24/06/2021 |
| Token No | SM/21-22/2533 24/06/2021 | Serial | 034 Last Visit: 24/06/2021 |
| Patient Name | Mrs. SAMPA ROY CHOWDHURY | Contact No | 8100147971 |
| Address | 3,MALLICK PARA BYE LANE SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||