Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03611 | Date 16/02/2019 |
| Token No | SM/21-22/7356 01/12/2021 | Serial | 005 Last Visit: 29/12/2021 |
| Patient Name | Mrs. KAMALA PAL | Contact No | 7278522620 |
| Address | 023/1 CHATRA KUMARPARA SERAMPORE | Age | 66 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||