Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10143 | Date 27/09/2021 |
| Token No | SM/21-22/5541 27/09/2021 | Serial | 039 Last Visit: 29/10/2021 |
| Patient Name | Mrs. MALATI DALAL | Contact No | 7450863909 |
| Address | 25,SATCHASI PARA SERAMPORE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||