Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 06528 | Date 24/09/2019 |
| Token No | SM/19-20/12896 07/11/2019 | Serial | 067 Last Visit: 19/03/2020 |
| Patient Name | Mrs. RUPALI PAL | Contact No | 6290093081 |
| Address | MIRPARA LANE SANKAR PALLY BAIDYABATI(M) | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||