Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10310 | Date 22/11/2021 |
| Token No | SM/21-22/6961 22/11/2021 | Serial | 001 Last Visit: 10/05/2022 |
| Patient Name | Mrs. KAUSALLA DEY | Contact No | 8336933712 |
| Address | PAHALAMPUR,DEY PARA,SIGURE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||