Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08226 | Date 05/05/2020 |
| Token No | SM/20-21/26459 08/10/2020 | Serial | 022 Last Visit: 08/10/2020 |
| Patient Name | Mrs. PRIYANKA BASAK | Contact No | 9903537369 |
| Address | 15/G DR. BAGAN LANE | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||