Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04130 | Date 09/03/2019 |
| Token No | SM/21-22/3767 04/08/2021 | Serial | 034 Last Visit: 18/05/2022 |
| Patient Name | Mrs. IRA GHOSH | Contact No | 9051612177 |
| Address | 27 CHAKRABORTY LANE CHATRA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||