Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02631 | Date 21/12/2018 |
| Token No | SM/18-19/5578 21/12/2018 | Serial | 028 Last Visit: 05/09/2023 |
| Patient Name | Mrs. CHAITALI KORMAKER | Contact No | 7278025421 |
| Address | 25 CHAKRABORTY LANE | Age | 31 Years,8 Months,3 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||