Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00823 | Date 29/08/2018 |
| Token No | SM/18-19/1034 29/08/2018 | Serial | 040 Last Visit: 22/07/2021 |
| Patient Name | Mrs. PRIYANKA HALDAR | Contact No | 9832901705 |
| Address | BAGER BAGAN TELI PARA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||