Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 09803 | Date 06/07/2021 |
| Token No | SM/21-22/4198 19/08/2021 | Serial | 004 Last Visit: 19/08/2021 |
| Patient Name | Mrs. PAPIYA ADHIKARY | Contact No | 9073780654 |
| Address | 42/B K.M SHA STREET SERAMPORE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||