Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05255 | Date 27/05/2019 |
| Token No | SM/21-22/3008 08/07/2021 | Serial | 030 Last Visit: 13/09/2022 |
| Patient Name | Mrs. TAPASI DAS | Contact No | 6289183989 |
| Address | BYE SERAMPORE KALI TALA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||