Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06890 | Date 18/11/2019 |
| Token No | SM/19-20/13447 18/11/2019 | Serial | 022 Last Visit: 18/11/2019 |
| Patient Name | Mrs. SARNA PATRA | Contact No | 6297194338 |
| Address | 32/4 G.T ROAD NABOGRAM , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||