Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10259 | Date 30/10/2021 |
| Token No | SM/21-22/6467 30/10/2021 | Serial | 036 Last Visit: 30/10/2021 |
| Patient Name | Mrs. SADHANA BERA | Contact No | 9038831433 |
| Address | 23,E RAJA KI.L GHOSWAMI STREET | Age | 44 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||