Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02918 | Date 09/01/2019 |
| Token No | SM/18-19/6546 09/01/2019 | Serial | 035 Last Visit: 16/07/2022 |
| Patient Name | Mrs. JAYANTI DAS | Contact No | 9339665040 |
| Address | CHATRA BAGER BAGN , BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||