Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04622 | Date 08/04/2019 |
| Token No | SM/19-20/14241 29/11/2019 | Serial | 010 Last Visit: 29/11/2019 |
| Patient Name | Mrs. SUSAMA SIL | Contact No | |
| Address | NOBOGRAM BIBEKA NANDA SARANI,BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||