Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05383 | Date 11/06/2019 |
| Token No | SM/21-22/6726 09/11/2021 | Serial | 052 Last Visit: 25/07/2022 |
| Patient Name | Mrs. RUMA DAS | Contact No | 7059586137 |
| Address | 47/31 HARIJAN ROAD, BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||