Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05393 | Date 11/06/2019 |
| Token No | SM/19-20/10467 16/09/2019 | Serial | 068 Last Visit: 16/09/2019 |
| Patient Name | Mrs. JOSHANA DAS | Contact No | 9163101232 |
| Address | 107 FF CHATRA TETUL TALA ,BAIDYABATI(M) | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 91 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||