Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10406 | Date 11/12/2021 |
| Token No | SM/21-22/7697 11/12/2021 | Serial | 020 Last Visit: 27/12/2021 |
| Patient Name | Mrs. SUSHILA HARIJAN | Contact No | 6289752400 |
| Address | CHATRA SERAMPORE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||