Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09862 | Date 22/07/2021 |
| Token No | SM/21-22/3363 22/07/2021 | Serial | 040 Last Visit: 30/08/2022 |
| Patient Name | Mrs. ASHIMA ROY | Contact No | 9674369850 |
| Address | 21, A MUKHERJEE STREET CHATRA SERAMPORE | Age | 69 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||