Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02555 | Date 17/12/2018 |
| Token No | SM/20-21/30049 03/02/2021 | Serial | 001 Last Visit: 14/02/2022 |
| Patient Name | Mrs. PUSPA BELEL | Contact No | 9903452934 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI (M) | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||