Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10289 | Date 17/11/2021 |
| Token No | SM/21-22/6898 17/11/2021 | Serial | 025 Last Visit: 17/11/2021 |
| Patient Name | Mrs. URMILA MALLICK | Contact No | 9864364155 |
| Address | NEHRU NAGAR COLONY SERAMPORE | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||