Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09847 | Date 16/07/2021 |
| Token No | SM/21-22/3219 16/07/2021 | Serial | 005 Last Visit: 26/07/2021 |
| Patient Name | Mrs. SANGITA PRAMANIK | Contact No | 8017169772 |
| Address | GANGA DARSHAN RAJA K.L GHOSWAMI STREET SERAMPORE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||