Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09032 | Date 07/12/2020 |
| Token No | SM/21-22/4924 09/09/2021 | Serial | 022 Last Visit: 11/09/2021 |
| Patient Name | Mrs. SAMPA HATI | Contact No | 9432347905 |
| Address | 40 SHARAT CHANDRA CHATTOPADHAYAY SARANI (BAHIR SERAMPORE) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||