Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10107 | Date 22/09/2021 |
| Token No | SM/22-23/16942 20/09/2022 | Serial | 036 Last Visit: 20/09/2022 |
| Patient Name | Mrs. REBA DAS | Contact No | 9231377665 |
| Address | 185/1 BAGER BAGAN TELIPARA | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||