Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09857 | Date 22/07/2021 |
| Token No | SM/21-22/3328 22/07/2021 | Serial | 005 Last Visit: 22/07/2021 |
| Patient Name | Mrs. MOUMITA PYNE SEN | Contact No | 8334943930 |
| Address | 15,BANIAPARA LANE SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||