Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 11004 | Date 13/05/2022 |
| Token No | SM/22-23/12543 17/05/2022 | Serial | 053 Last Visit: 17/06/2022 |
| Patient Name | Mrs. MANI LAHA | Contact No | 8420866684 |
| Address | 130 E BARUI PARA LANE | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||