Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09806 | Date 06/07/2021 |
| Token No | SM/21-22/2929 06/07/2021 | Serial | 059 Last Visit: 06/07/2021 |
| Patient Name | Mrs. CHANPA KARMAKAR | Contact No | 8479937447 |
| Address | 22, FIRINGI DANGA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||