Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10060 | Date 08/09/2021 |
| Token No | SM/21-22/4882 08/09/2021 | Serial | 024 Last Visit: 25/09/2021 |
| Patient Name | Mrs. ATOSHI SIULI | Contact No | 7890662724 |
| Address | 5/B TARAPUKUR COLONY SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||