Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09766 | Date 29/06/2021 |
| Token No | SM/22-23/11275 01/04/2022 | Serial | 016 Last Visit: 01/04/2022 |
| Patient Name | Mrs. BINA PAL | Contact No | |
| Address | 12/C KALITALA LANE SERAMPORE | Age | 57YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||