Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00673 | Date 24/08/2018 |
| Token No | SM/19-20/10753 20/09/2019 | Serial | 044 Last Visit: 08/02/2022 |
| Patient Name | Mrs. BONANI BISWAS (ROY) | Contact No | 8481940913 |
| Address | 103 CHATRA TETULTALA | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||