Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10403 | Date 10/12/2021 |
| Token No | SM/21-22/7668 10/12/2021 | Serial | 031 Last Visit: 10/12/2021 |
| Patient Name | Mrs. DEBJANI SOM | Contact No | 9339586677 |
| Address | 124/C BARUI PARA LANE CHATRA SERAMPORE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||