Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07174 | Date 17/12/2019 |
| Token No | SM/21-22/3192 15/07/2021 | Serial | 022 Last Visit: 14/03/2022 |
| Patient Name | Mrs. JHARNA ROY | Contact No | |
| Address | 75/3 SINGTI SIBPUR SIBANIPUR, HAORA | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||