Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10401 | Date 09/12/2021 |
| Token No | SM/21-22/9451 29/01/2022 | Serial | 019 Last Visit: 01/02/2022 |
| Patient Name | Mrs. LALITA GHOSH | Contact No | 9051217765 |
| Address | 24,GHOSH PARA 1ST LANE CHATRA | Age | 85 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||