Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09123 | Date 05/01/2021 |
| Token No | SM/20-21/29023 05/01/2021 | Serial | 039 Last Visit: 05/01/2021 |
| Patient Name | Mrs. MENOKA PAL | Contact No | |
| Address | TELIPARA NBAGER BAGAN CHATRA, BAIDYABATI(M) | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||