Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10672 | Date 14/02/2022 |
| Token No | SM/21-22/9855 14/02/2022 | Serial | 031 Last Visit: 14/02/2022 |
| Patient Name | Mrs. GITA DEBI | Contact No | 7044731755 |
| Address | 19 KALITALA LANE CHATRA SERAMPORE | Age | 82 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||