Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08826 | Date 07/10/2020 |
| Token No | SM/20-21/27613 18/11/2020 | Serial | 035 Last Visit: 07/08/2021 |
| Patient Name | Mrs. BIMALA DEBI BARI | Contact No | 6290380007 |
| Address | 2 B L C MILLS MAHESH SERAMPORE | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||