Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09989 | Date 26/08/2021 |
| Token No | SM/21-22/4932 09/09/2021 | Serial | 030 Last Visit: 09/09/2021 |
| Patient Name | Mrs. CHOBI GHOSH | Contact No | |
| Address | 8 /A. A . P. GHOSH ROAD | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||