Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04178 | Date 11/03/2019 |
| Token No | SM/21-22/7800 15/12/2021 | Serial | 024 Last Visit: 20/12/2021 |
| Patient Name | Mrs. PRATIVA DAS | Contact No | 7044717545 |
| Address | DIARA GOBINDOPUR | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||