Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09764 | Date 28/06/2021 |
| Token No | SM/21-22/2655 28/06/2021 | Serial | 048 Last Visit: 28/06/2021 |
| Patient Name | Mrs. NOVELI CHAKRABORTY | Contact No | 7439830050 |
| Address | 9/J BARABAGAN LANE SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||