Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06600 | Date 08/10/2019 |
| Token No | SM/19-20/11527 08/10/2019 | Serial | 003 Last Visit: 08/10/2019 |
| Patient Name | Miss SUPRIYA DAS | Contact No | |
| Address | RAMKRISHNA ROAD , BAIDYBATI | Age | 18 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||