Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07147 | Date 14/12/2019 |
| Token No | SM/19-20/15256 14/12/2019 | Serial | 021 Last Visit: 02/01/2020 |
| Patient Name | Mrs. GYANTI DEVI | Contact No | 9330626464 |
| Address | 23 NIL BAGAN CHATRA CHATUGANG, BAIDYABATI(M) | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||