Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06931 | Date 20/11/2019 |
| Token No | SM/19-20/13645 20/11/2019 | Serial | 054 Last Visit: 26/08/2021 |
| Patient Name | Mrs. MONIKA DAS | Contact No | 8450818867 |
| Address | 301/T/N CHATRA TETULTALA BAGER BAGAN , BAIDYABATI(M) | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||