Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06814 | Date 07/11/2019 |
| Token No | SM/19-20/21377 20/04/2020 | Serial | 052 Last Visit: 02/11/2021 |
| Patient Name | Mrs. SUJATA MONDAL | Contact No | 9073336787 |
| Address | 11 MUSALMANPARA LANE | Age | 33 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||