Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04769 | Date 20/04/2019 |
| Token No | SM/19-20/1203 20/04/2019 | Serial | 024 Last Visit: 20/04/2019 |
| Patient Name | Mrs. SWAPANA BERA | Contact No | |
| Address | RAM KRISHNA NAGAR BAURI PARA , BAIDYABATI (M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||