Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 11922 | Date 15/02/2023 |
| Token No | SM/22-23/20266 15/02/2023 | Serial | 003 Last Visit: 15/02/2023 |
| Patient Name | Mrs. SHRABANI JANA | Contact No | 9933604068 |
| Address | 35 BARO BAGAN LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||