Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06379 | Date 12/09/2019 |
| Token No | SM/19-20/10192 12/09/2019 | Serial | 010 Last Visit: 23/09/2019 |
| Patient Name | Mrs. GITA DAS | Contact No | 9883480383 |
| Address | 240/47 G T ROAD CHATRA , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||