Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11689 | Date 21/11/2022 |
| Token No | SM/22-23/18069 21/11/2022 | Serial | 008 Last Visit: 02/12/2022 |
| Patient Name | Mrs. ANITA ADAK | Contact No | 9874628248 |
| Address | PAHALAMPUR, DIARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||