Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09771 | Date 30/06/2021 |
| Token No | SM/21-22/2699 30/06/2021 | Serial | 005 Last Visit: 30/06/2021 |
| Patient Name | Miss PIU NASKAR | Contact No | 9038827671 |
| Address | 5 NO COLONY SERAMPORE | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||