Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04613 | Date 08/04/2019 |
| Token No | SM/19-20/21443 22/04/2020 | Serial | 026 Last Visit: 23/12/2021 |
| Patient Name | Mrs. PADMA SOM | Contact No | 8902601090 |
| Address | 17 CHATRA DUTTES LANE | Age | 79 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||