Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01042 | Date 11/09/2018 |
| Token No | SM/18-19/1500 11/09/2018 | Serial | 030 Last Visit: 27/07/2022 |
| Patient Name | Mrs. LAKSHMI SAHA | Contact No | 9874178224 |
| Address | BOROBAGAN LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||