Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09561 | Date 30/04/2021 |
| Token No | SM/21-22/1034 30/04/2021 | Serial | 028 Last Visit: 30/04/2021 |
| Patient Name | Mrs. UJJALA SINGH | Contact No | 9748965924 |
| Address | RAJAR BAGAN BAIDHYABATI | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||