Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09100 | Date 28/12/2020 |
| Token No | SM/21-22/3022 09/07/2021 | Serial | 002 Last Visit: 29/10/2021 |
| Patient Name | Mrs. SUBHADRA DAS | Contact No | 9062785119 |
| Address | 10/A/2/Y/E G T ROAD BAIDYABATI M | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||