Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03063 | Date 18/01/2019 |
| Token No | SM/18-19/7023 18/01/2019 | Serial | 027 Last Visit: 16/04/2019 |
| Patient Name | Mrs. CHHOBI BHAGAT | Contact No | 9883736858 |
| Address | CHATRA TELI PARA , BAIDYABATI (M) | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||