Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03791 | Date 22/02/2019 |
| Token No | SM/21-22/5557 27/09/2021 | Serial | 055 Last Visit: 03/07/2023 |
| Patient Name | Mrs. PURABI DAS | Contact No | 9830404192 |
| Address | 3B CHATRA GHOSH PARA 2ND LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||