Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10275 | Date 15/11/2021 |
| Token No | SM/21-22/6812 15/11/2021 | Serial | 014 Last Visit: 15/11/2021 |
| Patient Name | Mrs. ANTARA MITRA GHOSH | Contact No | 8697511827 |
| Address | 42/.B S.C CHATTERJEE SARANI SERAMPORE | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||