Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04518 | Date 02/04/2019 |
| Token No | SM/19-20/129 02/04/2019 | Serial | 067 Last Visit: 02/04/2019 |
| Patient Name | Miss MANORAMA BEHERA | Contact No | 9051168155 |
| Address | CHATRA NABIN CHAKRABORTY LANE , BAIDYABATI(M) | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||