Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02157 | Date 27/11/2018 |
| Token No | SM/20-21/27734 24/11/2020 | Serial | 053 Last Visit: 02/11/2021 |
| Patient Name | Mrs. SIKHA RAY | Contact No | 9051479445 |
| Address | 11, DR. G.C GOSWAMI STREET | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||