Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05426 | Date 14/06/2019 |
| Token No | SM/19-20/10452 16/09/2019 | Serial | 053 Last Visit: 27/09/2022 |
| Patient Name | Mrs. CHAINA MAJHI | Contact No | 8583020448 |
| Address | 40/8 GODAR BAGAN BYE LANE CHATRA , BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||