Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05124 | Date 15/05/2019 |
| Token No | SM/21-22/5997 18/10/2021 | Serial | 033 Last Visit: 04/07/2022 |
| Patient Name | Mrs. JAYANTI DAS | Contact No | 9874147956 |
| Address | 4/A DR. D.C GHOSWAMI STREET | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||