Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10295 | Date 17/11/2021 |
| Token No | SM/21-22/6904 17/11/2021 | Serial | 031 Last Visit: 17/11/2021 |
| Patient Name | Mrs. ANIMA PATRA | Contact No | 9804413084 |
| Address | 19/A/1 SANI PARA LANE SERAMPORE | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||