Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08081 | Date 15/04/2020 |
| Token No | SM/19-20/25311 02/09/2020 | Serial | 010 Last Visit: 10/02/2022 |
| Patient Name | Miss NIBEDITA DAS | Contact No | 9830298275 |
| Address | 312 DR. G. C. GOSWAMI STREET | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||