Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02453 | Date 10/12/2018 |
| Token No | SM/19-20/12107 21/10/2019 | Serial | 004 Last Visit: 29/12/2021 |
| Patient Name | Mrs. ASHA MONDAL | Contact No | 7686830295 |
| Address | 31A BORO BAGAN,SIBTALA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||