Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09013 | Date 01/12/2020 |
| Token No | SM/21-22/6267 26/10/2021 | Serial | 021 Last Visit: 26/09/2023 |
| Patient Name | Mrs. ANITA DAS | Contact No | 9073441255 |
| Address | S. S. BOSE SARANI,BAIDYABATI CHAK,BAIDYABATI(M) | Age | 35 Years,8 Months,24 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||