Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 15786 | Date 29/07/2025 |
| Token No | SM/25-26/4231 29/07/2025 | Serial | 007 Last Visit: 29/07/2025 |
| Patient Name | Mrs. JHOLON SATH | Contact No | |
| Address | 18 NO K.D LANE | Age | 61 Years,5 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||