Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11211 | Date 29/06/2022 |
| Token No | SM/22-23/15691 13/08/2022 | Serial | 020 Last Visit: 13/08/2022 |
| Patient Name | Mrs. SHYAMALI PRODHAN | Contact No | 8013883212 |
| Address | SARDAR PARA CHOTOBELU BELUMILKI, | Age | 34 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||