Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09855 | Date 19/07/2021 |
| Token No | SM/21-22/3296 19/07/2021 | Serial | 014 Last Visit: 19/08/2021 |
| Patient Name | Mrs. RINKU GHOSH | Contact No | 7980697554 |
| Address | 56, CHATRA SHITALA TALA SERAMPORE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||