Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09917 | Date 07/08/2021 |
| Token No | SM/21-22/3848 07/08/2021 | Serial | 019 Last Visit: 07/08/2021 |
| Patient Name | Miss MISTY CHOWDHURY | Contact No | 9674309167 |
| Address | 16/RAJA K.L GHOSWAMI STREET | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||