Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10405 | Date 11/12/2021 |
| Token No | SM/21-22/7691 11/12/2021 | Serial | 014 Last Visit: 11/12/2021 |
| Patient Name | Mrs. SANDHYA DHARA | Contact No | |
| Address | BAGER BAGAN BAIDHYABATI | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||