Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09124 | Date 05/01/2021 |
| Token No | SM/21-22/601 20/04/2021 | Serial | 010 Last Visit: 25/05/2021 |
| Patient Name | Mrs. PURNIMA DE | Contact No | 9163229145 |
| Address | PAHALMPUR , SINGUR | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||