Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06734 | Date 22/10/2019 |
| Token No | SM/19-20/12233 22/10/2019 | Serial | 056 Last Visit: 22/10/2019 |
| Patient Name | Mrs. SOMA JANA | Contact No | 9432592942 |
| Address | 142/A/2 GT ROAD CHATRA , BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||