Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10639 | Date 08/02/2022 |
| Token No | SM/21-22/10727 12/03/2022 | Serial | 028 Last Visit: 09/06/2022 |
| Patient Name | Mrs. SOMA HALDER | Contact No | 9330246307 |
| Address | 1 KANAI DEYAN TALA LANE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||