Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 10450 | Date 23/12/2021 |
| Token No | SM/21-22/9918 16/02/2022 | Serial | 004 Last Visit: 11/03/2022 |
| Patient Name | Mrs. PADMA DEY | Contact No | 9382587475 |
| Address | 7/A CHATRA DHARMOTALA LANE SERAMPORE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||