Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01047 | Date 11/09/2018 |
| Token No | SM/21-22/1468 17/05/2021 | Serial | 053 Last Visit: 04/04/2022 |
| Patient Name | Mrs. SAMPA SARKAR | Contact No | 9163120630 |
| Address | 200 CHATRA TELI PARA BAGER BAGAN , BAIDYABATI (M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||