Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10420 | Date 15/12/2021 |
| Token No | SM/21-22/7789 15/12/2021 | Serial | 013 Last Visit: 15/12/2021 |
| Patient Name | Mrs. KOUSHALLYA BISWAS | Contact No | 705941463 |
| Address | CHATRA SHITALA TALA SERAMPORE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||