Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02247 | Date 30/11/2018 |
| Token No | SM/18-19/4459 30/11/2018 | Serial | 048 Last Visit: 23/10/2021 |
| Patient Name | Mrs. KALPANA MALLICK | Contact No | |
| Address | CHATRA BAGER BAGAN,BAIDAYBATY(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||