Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09160 | Date 11/01/2021 |
| Token No | SM/20-21/29274 11/01/2021 | Serial | 036 Last Visit: 11/01/2021 |
| Patient Name | Mrs. ARTI MAHATO | Contact No | 9007555681 |
| Address | 55/1 SATCHASI PARA,LANKER BAGAN,BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||