Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10407 | Date 13/12/2021 |
| Token No | SM/21-22/7704 13/12/2021 | Serial | 001 Last Visit: 13/12/2021 |
| Patient Name | Mrs. RINA SHAW | Contact No | 8100003625 |
| Address | 301/J/C TELIPARA CHATRA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | 150 cm BMI: 31.111111 |
| Diagnosis | |||