Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10117 | Date 23/09/2021 |
| Token No | SM/21-22/5368 23/09/2021 | Serial | 013 Last Visit: 23/09/2021 |
| Patient Name | Mrs. ANU BISWAS MONDAL | Contact No | 9062602019 |
| Address | 71/A,MALLICK PARA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||