Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09673 | Date 04/06/2021 |
| Token No | SM/21-22/3737 04/08/2021 | Serial | 004 Last Visit: 04/08/2021 |
| Patient Name | Mrs. PURNIMA CHATTERJEE | Contact No | 9874345214 |
| Address | 12/O BARIN GHOSH LANE SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||