Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10431 | Date 18/12/2021 |
| Token No | SM/21-22/7878 18/12/2021 | Serial | 004 Last Visit: 20/01/2022 |
| Patient Name | Mrs. MALATI DAS | Contact No | 9339387357 |
| Address | 24 MUSALMAN PARTA ROADF SHEORAPHULI | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||