Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09578 | Date 03/05/2021 |
| Token No | SM/21-22/7649 10/12/2021 | Serial | 012 Last Visit: 02/06/2023 |
| Patient Name | Miss MOUBONI DAS | Contact No | 6291961228 |
| Address | 437/B,CRIPER ROAD,KONNAGAR | Age | 17YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||