Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02791 | Date 02/01/2019 |
| Token No | SM/21-22/1372 13/05/2021 | Serial | 007 Last Visit: 23/08/2021 |
| Patient Name | Mrs. RUBI ROY | Contact No | 8478061306 |
| Address | 34/B PROVHASH NAGER | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||