Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01047 | Date 11/09/2018 |
| Token No | SM/18-19/9487 26/02/2019 | Serial | 040 Last Visit: 04/04/2022 |
| Patient Name | Mrs. SAMPA SARKAR | Contact No | 9163120630 |
| Address | 200 CHATRA TELI PARA BAGER BAGAN , BAIDYABATI (M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 87 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||