Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10200 | Date 18/10/2021 |
| Token No | SM/21-22/5993 18/10/2021 | Serial | 029 Last Visit: 18/10/2021 |
| Patient Name | Mrs. RAMALA GHOSH | Contact No | |
| Address | 8,A BHADURI PARA LANE CHATRA SERAMPORE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||