Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03039 | Date 17/01/2019 |
| Token No | SM/21-22/4356 24/08/2021 | Serial | 045 Last Visit: 24/08/2021 |
| Patient Name | Mrs. HEMA GAYAN | Contact No | |
| Address | CHATRA LANKAR BAGAN | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||