Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06872 | Date 15/11/2019 |
| Token No | SM/19-20/13309 15/11/2019 | Serial | 042 Last Visit: 15/11/2019 |
| Patient Name | Mrs. SABITA KAYAL | Contact No | 9007482847 |
| Address | BAGER BAGNA TELI , BAIDYABTI | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||