Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03628 | Date 18/02/2019 |
| Token No | SM/21-22/6209 25/10/2021 | Serial | 031 Last Visit: 03/02/2022 |
| Patient Name | Mrs. JHARNA LAHA | Contact No | 9051548841 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||