Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03255 | Date 31/01/2019 |
| Token No | SM/21-22/2217 14/06/2021 | Serial | 009 Last Visit: 14/06/2021 |
| Patient Name | Mrs. SAMPA MANDOL | Contact No | 8013879495 |
| Address | GHOSH PARA FAST LANE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||