Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09972 | Date 23/08/2021 |
| Token No | SM/21-22/4281 23/08/2021 | Serial | 025 Last Visit: 23/08/2021 |
| Patient Name | Mrs. GITA ROY | Contact No | |
| Address | 40,KUMIRJALA ROAD SERAMPORE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||