Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02149 | Date 27/11/2018 |
| Token No | SM/18-19/5691 24/12/2018 | Serial | 014 Last Visit: 27/01/2021 |
| Patient Name | Mrs. SHAMPA SOM | Contact No | 6291058911 |
| Address | CHATRA DUTTA PARA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||