Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06877 | Date 15/11/2019 |
| Token No | SM/19-20/13335 15/11/2019 | Serial | 068 Last Visit: 15/11/2019 |
| Patient Name | Mrs. DOLA DAS | Contact No | 7001068293 |
| Address | 243/89/1 TELI PARA LANE CHATRA , BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||