Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01835 | Date 01/11/2018 |
| Token No | SM/18-19/5332 17/12/2018 | Serial | 013 Last Visit: 22/11/2021 |
| Patient Name | Mrs. CHABI BERA | Contact No | 9874177160 |
| Address | 24/1 CHAKRABORTY LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||