Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03008 | Date 15/01/2019 |
| Token No | SM/19-20/1223 20/04/2019 | Serial | 044 Last Visit: 19/03/2021 |
| Patient Name | Mrs. SWAPNA DAS | Contact No | 9804922977 |
| Address | BAHIR SERAMPORE, KALITALA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||