Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10123 | Date 24/09/2021 |
| Token No | SM/21-22/5406 24/09/2021 | Serial | 001 Last Visit: 24/09/2021 |
| Patient Name | Mrs. PRATIMA MAJHI | Contact No | |
| Address | 78/1 RAM KRISHNA ROAD,BAIDYABATI(M) | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||