Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04771 | Date 20/04/2019 |
| Token No | SM/19-20/1211 20/04/2019 | Serial | 032 Last Visit: 22/08/2019 |
| Patient Name | Mrs. DURGA SANTI DAS | Contact No | 7890841156 |
| Address | 39 CHATRA PATTI PARA , BAIDYABATI(M) | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||