Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10202 | Date 18/10/2021 |
| Token No | SM/21-22/6012 18/10/2021 | Serial | 048 Last Visit: 02/11/2021 |
| Patient Name | Mrs. SUMITA GHOSH | Contact No | 8274009895 |
| Address | 25/A,GHOSH PARA SERAMPORE | Age | 57 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||