Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 10108 | Date 22/09/2021 |
| Token No | SM/21-22/5331 22/09/2021 | Serial | 007 Last Visit: 16/08/2022 |
| Patient Name | Mrs. SAPNA BERA | Contact No | 7278317560 |
| Address | 3 PARSI LANE,SIL BAGAN | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||