Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10218 | Date 23/10/2021 |
| Token No | SM/21-22/9314 25/01/2022 | Serial | 019 Last Visit: 04/11/2024 |
| Patient Name | Mrs. NIYASA BEGAM | Contact No | 8961355762 |
| Address | 91/D,MIYAJAN DARJEE LANE,MALLICK PARA | Age | 47 Years,10 Months,2 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||