Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09913 | Date 05/08/2021 |
| Token No | SM/21-22/3790 05/08/2021 | Serial | 022 Last Visit: 05/08/2021 |
| Patient Name | Mrs. JYOTSNA PAL | Contact No | |
| Address | 31,SHITALA TALA ROAD CHATRA SERAMPORE | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||