Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09858 | Date 22/07/2021 |
| Token No | SM/21-22/3333 22/07/2021 | Serial | 010 Last Visit: 22/07/2021 |
| Patient Name | Mrs. DIPALI JANA | Contact No | 9163774773 |
| Address | 175 SHITALA TALA ROAD CHATRA SERAMPORE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||