Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05814 | Date 17/07/2019 |
| Token No | SM/20-21/27045 02/11/2020 | Serial | 040 Last Visit: 24/05/2022 |
| Patient Name | Mrs. SHRABANI DAS | Contact No | 9163681165 |
| Address | 212 TELIPARA,BAGHER BAGAN,BAIDYABATI(M) | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||