Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09510 | Date 22/04/2021 |
| Token No | SM/21-22/694 22/04/2021 | Serial | 029 Last Visit: 22/04/2021 |
| Patient Name | Mrs. PIYALI DAS | Contact No | 7980924264 |
| Address | 3/C GHOSH PARA SERAMPORE | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||