Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09937 | Date 13/08/2021 |
| Token No | SM/21-22/4028 13/08/2021 | Serial | 023 Last Visit: 08/09/2021 |
| Patient Name | Mrs. PURNIMA BORAL | Contact No | |
| Address | 13,BENIA PARA LANE SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||