Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04378 | Date 25/03/2019 |
| Token No | SM/18-19/11177 25/03/2019 | Serial | 097 Last Visit: 27/03/2019 |
| Patient Name | Mrs. KRISHNA JOSH | Contact No | 8981728044 |
| Address | CHATRA PAMPA NAGAR GT ROAD, BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||