Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09091 | Date 23/12/2020 |
| Token No | SM/20-21/28715 23/12/2020 | Serial | 012 Last Visit: 20/03/2021 |
| Patient Name | Mrs. BRINDA SAH | Contact No | 9163402196 |
| Address | 254 RAMKRISHNA ROAD BAIDYABATI (M) | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||