Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10155 | Date 28/09/2021 |
| Token No | SM/21-22/5596 28/09/2021 | Serial | 028 Last Visit: 28/09/2021 |
| Patient Name | Mrs. NANDA CHAKRABORTY | Contact No | 6290252414 |
| Address | 15,BRAJA DUTTA LANE SERAMPORE | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||