Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06571 | Date 27/09/2019 |
| Token No | SM/19-20/11269 27/09/2019 | Serial | 080 Last Visit: 27/09/2019 |
| Patient Name | Mrs. MAYA RANI MANNA | Contact No | |
| Address | CHATRA BAGHER BAGAN,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||