Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06678 | Date 17/10/2019 |
| Token No | SM/19-20/11961 17/10/2019 | Serial | 071 Last Visit: 25/09/2020 |
| Patient Name | Mrs. MAYA SHAW | Contact No | 8420934527 |
| Address | 108 CHATRA TELI PARA BAGER BAGAN , BAIDYBATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||