Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03091 | Date 19/01/2019 |
| Token No | SM/18-19/7102 19/01/2019 | Serial | 035 Last Visit: 04/04/2020 |
| Patient Name | Mrs. SANDHYA RANI PAGRE | Contact No | |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 46.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||