Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10174 | Date 04/10/2021 |
| Token No | SM/21-22/6257 26/10/2021 | Serial | 011 Last Visit: 05/01/2022 |
| Patient Name | Mrs. KARABI PYNE | Contact No | 9831365893 |
| Address | 15,BENIA PARA LANE SERAMPORE | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||