Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 10304 | Date 18/11/2021 |
| Token No | SM/21-22/6916 18/11/2021 | Serial | 003 Last Visit: 18/11/2021 |
| Patient Name | Mrs. MALLIKA PAL | Contact No | 8276859182 |
| Address | BIDHAN POLLI SHEORAPHULY | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||