Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09894 | Date 30/07/2021 |
| Token No | SM/21-22/3631 30/07/2021 | Serial | 015 Last Visit: 30/07/2021 |
| Patient Name | Mrs. PREMJIT KAUR | Contact No | 968150609 |
| Address | 107/F/F,G.T ROAD BAIDHYABATI | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||