Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11050 | Date 26/05/2022 |
| Token No | SM/22-23/12915 26/05/2022 | Serial | 021 Last Visit: 13/06/2022 |
| Patient Name | Mrs. SOMA DAS | Contact No | 6289704310 |
| Address | 3/B, GHOSH PARA 2ND LANE CHATRA SERAMPORE | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||