Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09942 | Date 14/08/2021 |
| Token No | SM/21-22/4749 04/09/2021 | Serial | 018 Last Visit: 04/09/2021 |
| Patient Name | Mrs. CHAMPA DAS | Contact No | 9163948033 |
| Address | 23/A AKRA BATI LANE SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||