Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05976 | Date 27/07/2019 |
| Token No | SM/20-21/30194 01/03/2021 | Serial | 014 Last Visit: 29/10/2021 |
| Patient Name | Mrs. ASHOKA DAS | Contact No | 7596954502 |
| Address | 65/3 FIRANGI DANGA ROADMALLIKA PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||