Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10256 | Date 30/10/2021 |
| Token No | SM/21-22/6450 30/10/2021 | Serial | 019 Last Visit: 30/10/2021 |
| Patient Name | Mrs. NABANITA POREL | Contact No | 9004771110 |
| Address | 14,CHANPATALA LANE SERAMPORE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||