Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 10080 | Date 13/09/2021 |
| Token No | SM/21-22/5053 13/09/2021 | Serial | 043 Last Visit: 14/09/2021 |
| Patient Name | Mrs. ISHRAT JAHAN | Contact No | 9123663995 |
| Address | 4, ROY GHAT LANE SERAMPORE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||