Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01877 | Date 03/11/2018 |
| Token No | SM/21-22/2307 17/06/2021 | Serial | 003 Last Visit: 27/06/2022 |
| Patient Name | Mrs. SUJATA SOM | Contact No | 9874581489 |
| Address | 24 B CHATRA BARUI PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||