Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10319 | Date 22/11/2021 |
| Token No | SM/21-22/7005 22/11/2021 | Serial | 045 Last Visit: 22/11/2021 |
| Patient Name | Mrs. REKHA PAL | Contact No | 9432315445 |
| Address | 31,M.C LAHIRI STREET SERAMPORE | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||