Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01861 | Date 02/11/2018 |
| Token No | SM/21-22/1665 24/05/2021 | Serial | 043 Last Visit: 17/08/2021 |
| Patient Name | Mrs. SHIBANI DAS | Contact No | 9163729057 |
| Address | 43B CHATRA DUTTA PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||