Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00107 | Date 04/08/2018 |
| Token No | SM/22-23/30601 21/03/2024 | Serial | 058 Last Visit: 04/05/2024 |
| Patient Name | Mrs. MOUMITA DAS | Contact No | |
| Address | SERAMPORE | Age | 31 Years,5 Months,2 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||