Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07069 | Date 04/12/2019 |
| Token No | SM/19-20/24291 21/07/2020 | Serial | 006 Last Visit: 03/01/2023 |
| Patient Name | Mrs. BULA DOLUI | Contact No | 8335901921 |
| Address | 40A BARO BAGAN LANE SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||