Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04877 | Date 23/04/2019 |
| Token No | SM/21-22/6872 16/11/2021 | Serial | 040 Last Visit: 28/02/2022 |
| Patient Name | Mrs. PUSHAPA MAJHI | Contact No | 9903365186 |
| Address | 23 BANIYA PARA LANE SERAMPORE | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||