Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00092 | Date 03/08/2018 |
| Token No | SM/22-23/25713 30/10/2023 | Serial | 039 Last Visit: 04/07/2024 |
| Patient Name | Mrs. CHAYA DAS | Contact No | |
| Address | 90 , BHATCHARJEE ST. | Age | 78 Years,6 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||