Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10396 | Date 08/12/2021 |
| Token No | SM/21-22/7583 08/12/2021 | Serial | 037 Last Visit: 08/12/2021 |
| Patient Name | Mrs. SABITA DEY | Contact No | 8777366382 |
| Address | 9,CHATRA BAZAR SERAMPORE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||