Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10099 | Date 17/09/2021 |
| Token No | SM/21-22/5179 17/09/2021 | Serial | 002 Last Visit: 17/09/2021 |
| Patient Name | Mrs. MALABIKA GHOSH | Contact No | |
| Address | 16,AP.GHOSH ROAD CHATRA SERAMPORE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||