Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02043 | Date 19/11/2018 |
| Token No | SM/21-22/1914 04/06/2021 | Serial | 009 Last Visit: 15/02/2022 |
| Patient Name | Mrs. SANTANA SOM | Contact No | 8902601090 |
| Address | 17, CHATRA DUTTAS LANE | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||