Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09678 | Date 05/06/2021 |
| Token No | SM/21-22/1947 05/06/2021 | Serial | 002 Last Visit: 18/03/2023 |
| Patient Name | Mrs. MONDIRA DEY | Contact No | |
| Address | TELIPARA BAGER BAGAN BAIDHYABATI | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||