Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10074 | Date 11/09/2021 |
| Token No | SM/21-22/5473 25/09/2021 | Serial | 012 Last Visit: 25/09/2021 |
| Patient Name | Mrs. SOMA SANS | Contact No | 7501830571 |
| Address | BAKSHA | Age | 35 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||