Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02550 | Date 17/12/2018 |
| Token No | SM/18-19/5681 24/12/2018 | Serial | 004 Last Visit: 20/09/2021 |
| Patient Name | Mrs. ASOKHA JALUI | Contact No | 8420988301 |
| Address | CHATRA BAGHER BAGAN,BAIDYABATY (M) | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||