Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10679 | Date 18/02/2022 |
| Token No | SM/21-22/10269 25/02/2022 | Serial | 025 Last Visit: 23/03/2022 |
| Patient Name | Mrs. LAXMI RANI ROY | Contact No | 8420999830 |
| Address | 24/B CHARABAGAN BAUREPARA BAIDYABATI SHEARAPHULI | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||