Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03121 | Date 21/01/2019 |
| Token No | SM/18-19/8964 18/02/2019 | Serial | 137 Last Visit: 29/02/2020 |
| Patient Name | Mrs. RINA ADHIKARY | Contact No | 8420336639 |
| Address | 14 MITRA BAGAN G T ROAD , BAIDYABATI (M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||