Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03486 | Date 12/02/2019 |
| Token No | SM/18-19/11605 30/03/2019 | Serial | 020 Last Visit: 06/04/2019 |
| Patient Name | Mrs. DIPA DAS | Contact No | 9163888292 |
| Address | BCHATRA ,DAS PARA,HARIJON ROAD, BAIDYABATI(M) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||