Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10270 | Date 12/11/2021 |
| Token No | SM/21-22/6793 12/11/2021 | Serial | 067 Last Visit: 12/11/2021 |
| Patient Name | Mrs. `KANAK RUIDAS | Contact No | |
| Address | PAMPA NAGAR BAIDYABATI | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||