Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10009 | Date 31/08/2021 |
| Token No | SM/21-22/4591 31/08/2021 | Serial | 044 Last Visit: 31/08/2021 |
| Patient Name | Mrs. CHAMPA DALAL | Contact No | 9836659072 |
| Address | 14/B DHARMATALA BYE LANE CHATRA SERAMPORE | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||