Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08869 | Date 15/10/2020 |
| Token No | SM/20-21/26675 15/10/2020 | Serial | 018 Last Visit: 25/09/2021 |
| Patient Name | Mrs. SUMITA MALIK | Contact No | 6291093565 |
| Address | 301/T/J/E TELIPARA,BAHER BAGAN,BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||