Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09577 | Date 03/05/2021 |
| Token No | SM/21-22/1083 03/05/2021 | Serial | 031 Last Visit: 03/05/2021 |
| Patient Name | Mrs. SUSHAMA BHOWMIK | Contact No | |
| Address | DASPARA DAKSHIN RAJHYADHARPUR | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||