Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09842 | Date 14/07/2021 |
| Token No | SM/21-22/3166 14/07/2021 | Serial | 039 Last Visit: 14/07/2021 |
| Patient Name | Mrs. MAONA ROY | Contact No | |
| Address | 107/F,G.T ROAD BAIDHYABATI | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||