Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09136 | Date 06/01/2021 |
| Token No | SM/20-21/29101 06/01/2021 | Serial | 034 Last Visit: 22/01/2021 |
| Patient Name | Mrs. KIRAN SAH | Contact No | 9883119893 |
| Address | 254 RAMKRISHNA ROAD BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||