Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09667 | Date 02/06/2021 |
| Token No | SM/21-22/1869 02/06/2021 | Serial | 023 Last Visit: 22/07/2021 |
| Patient Name | Mrs. RUPALI PAL | Contact No | 9831573538 |
| Address | 146/G.T ROAD CHATRA BAHUBAZAR | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||