Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09774 | Date 30/06/2021 |
| Token No | SM/21-22/2710 30/06/2021 | Serial | 016 Last Visit: 03/07/2021 |
| Patient Name | Miss RAI CHATTERJEE | Contact No | 9679768891 |
| Address | CHAKRABORTY LANE SERAMPORE | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||