Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02745 | Date 31/12/2018 |
| Token No | SM/18-19/10707 18/03/2019 | Serial | 006 Last Visit: 22/08/2022 |
| Patient Name | Miss SUPRITY PAL | Contact No | 8902294180 |
| Address | GOBINDO PUR P.O-DIARA, P.S-SINGUR | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||