Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01545 | Date 06/10/2018 |
| Token No | SM/21-22/10003 18/02/2022 | Serial | 058 Last Visit: 03/12/2025 |
| Patient Name | Mrs. KALPANA PAL | Contact No | 9051025893 |
| Address | CHATRA BOU BAZAR | Age | 67 Years,11 Months,1 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||