Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05926 | Date 24/07/2019 |
| Token No | SM/21-22/10040 19/02/2022 | Serial | 028 Last Visit: 26/03/2022 |
| Patient Name | Mrs. GITA BAIRAGI | Contact No | 9903268518 |
| Address | 46/ A PATUA PARA SERAMPORE | Age | 71 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||