Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07034 | Date 02/12/2019 |
| Token No | SM/19-20/14409 02/12/2019 | Serial | 002 Last Visit: 02/12/2019 |
| Patient Name | Mrs. PUSPA JANA | Contact No | 9830778479 |
| Address | 169 SHITALATALA ROAD CHATRA , BAIDYABATI(M) | Age | 64 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||