Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10186 | Date 07/10/2021 |
| Token No | SM/21-22/7117 24/11/2021 | Serial | 034 Last Visit: 24/11/2021 |
| Patient Name | Mrs. MOU BANERJEE | Contact No | 8420615346 |
| Address | 56 DUTTA PARA SERAMPORE CHATRA | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||