Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10269 | Date 12/11/2021 |
| Token No | SM/21-22/6780 12/11/2021 | Serial | 054 Last Visit: 12/11/2021 |
| Patient Name | Mrs. MIRA SARKAR | Contact No | 9163120630 |
| Address | 66/2 TELIPARA LANE CHATRA BAIDHYABATI | Age | 59 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||