Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04768 | Date 20/04/2019 |
| Token No | SM/19-20/1201 20/04/2019 | Serial | 022 Last Visit: 20/04/2019 |
| Patient Name | Mrs. NIRMALA DEVI PODAR | Contact No | |
| Address | RAM KRISHNA NAGAR BAURI PARA , BAIDYABATI (M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||