Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10279 | Date 15/11/2021 |
| Token No | SM/21-22/6831 15/11/2021 | Serial | 033 Last Visit: 15/11/2021 |
| Patient Name | Mrs. SARMILA SEAL | Contact No | |
| Address | 54 CHATRA SERAMPORE | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||