Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10731 | Date 28/02/2022 |
| Token No | SM/21-22/10327 28/02/2022 | Serial | 033 Last Visit: 07/03/2022 |
| Patient Name | Mrs. SURAVI PAL | Contact No | 8017956474 |
| Address | 90/B G T ROAD BAIDYABATI CHATRA | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||