Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03850 | Date 25/02/2019 |
| Token No | SM/19-20/10822 21/09/2019 | Serial | 031 Last Visit: 21/09/2019 |
| Patient Name | Mrs. SABITA DAS | Contact No | 9804704162 |
| Address | SATCHACI PARA,BAIDYABATI(M) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 78 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||