Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12236 | Date 13/07/2023 |
| Token No | SM/22-23/22865 13/07/2023 | Serial | 023 Last Visit: 13/07/2023 |
| Patient Name | Miss RUPREKHA SOM | Contact No | 9339037247 |
| Address | 127 BARUI PARA LANE CHATRA SERAMPORE | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||