Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10194 | Date 08/10/2021 |
| Token No | SM/21-22/5906 08/10/2021 | Serial | 028 Last Visit: 08/10/2021 |
| Patient Name | Mrs. LATIKA DAS | Contact No | 9874778868 |
| Address | 18/A VIVEKANANDA LANE SERAMPORE | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||