Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06907 | Date 19/11/2019 |
| Token No | SM/19-20/13548 19/11/2019 | Serial | 045 Last Visit: 19/11/2019 |
| Patient Name | Mrs. JYOTSNA DAS | Contact No | 8420971317 |
| Address | 15/32/B/N GODAR BAGAN BYE LANE CHATRA , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||