Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10395 | Date 08/12/2021 |
| Token No | SM/21-22/7557 08/12/2021 | Serial | 011 Last Visit: 08/12/2021 |
| Patient Name | Miss ARTI DAS | Contact No | 7439626216 |
| Address | 8/KANAI DEWAN TALA BYE LANE SERAMPORE | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||