Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09821 | Date 08/07/2021 |
| Token No | SM/21-22/3005 08/07/2021 | Serial | 027 Last Visit: 08/07/2021 |
| Patient Name | Miss DISHA MAITY | Contact No | 8017284797 |
| Address | 75/96/D CHATRA SERAMPORE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||