Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09760 | Date 28/06/2021 |
| Token No | SM/21-22/2621 28/06/2021 | Serial | 014 Last Visit: 28/06/2021 |
| Patient Name | Mrs. ADHIRA KARMAKAR | Contact No | |
| Address | 168/A DEWAN BAGAN BAIDYABATI | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||