Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01523 | Date 05/10/2018 |
| Token No | SM/19-20/14732 05/12/2019 | Serial | 060 Last Visit: 19/03/2021 |
| Patient Name | Mrs. RUKSA BEGAM | Contact No | 9681319906 |
| Address | 20 CHATRA KUMARPARA LANE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||