Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 10360 | Date 29/11/2021 |
| Token No | SM/21-22/7304 29/11/2021 | Serial | 030 Last Visit: 29/11/2021 |
| Patient Name | Mrs. PAMPA SAHA | Contact No | |
| Address | 341 GOLABAG NICHU MATH BAIDHYABATI | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||