Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08754 | Date 18/09/2020 |
| Token No | SM/20-21/25815 18/09/2020 | Serial | 065 Last Visit: 02/06/2023 |
| Patient Name | Mrs. PINKU CHOUDHURY | Contact No | 8481032083 |
| Address | 30/T/1 TELIPARA BAGER BAGAN, BAIDYABATI(M) | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||