Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03109 | Date 21/01/2019 |
| Token No | SM/21-22/5904 08/10/2021 | Serial | 026 Last Visit: 08/10/2021 |
| Patient Name | Mrs. SONALI MONDAL | Contact No | 9836324527 |
| Address | 58 DUTTA PARA LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||