Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01947 | Date 14/11/2018 |
| Token No | SM/18-19/4838 07/12/2018 | Serial | 032 Last Visit: 31/12/2020 |
| Patient Name | Mrs. SUBHANKARI ROY | Contact No | 9874782635 |
| Address | CHATRA BAGHER BAGAN | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||