Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10254 | Date 30/10/2021 |
| Token No | SM/21-22/6439 30/10/2021 | Serial | 008 Last Visit: 30/10/2021 |
| Patient Name | Mrs. ARCHANA SARDAR | Contact No | 8583925019 |
| Address | CHATRA SHEORAPHULI | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||