Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10004 | Date 28/08/2021 |
| Token No | SM/21-22/6128 22/10/2021 | Serial | 059 Last Visit: 22/10/2021 |
| Patient Name | Mrs. MITALI ROY | Contact No | 9830305569 |
| Address | BALLY | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||