Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04196 | Date 13/03/2019 |
| Token No | SM/18-19/10749 18/03/2019 | Serial | 048 Last Visit: 19/08/2019 |
| Patient Name | Mrs. TUMPA BAG | Contact No | 9164705513 |
| Address | 204/78/G CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||