Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01680 | Date 26/10/2018 |
| Token No | SM/20-21/31287 30/03/2021 | Serial | 014 Last Visit: 30/08/2022 |
| Patient Name | Mrs. GITA SOM | Contact No | 7890781765 |
| Address | 46, CHATRA BARUI PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||