Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 04878 | Date 24/04/2019 |
| Token No | SM/19-20/1531 24/04/2019 | Serial | 001 Last Visit: 24/04/2019 |
| Patient Name | Mrs. PURNIMA NAYAK | Contact No | |
| Address | HARJAN PALLI GHOSH MARKET SHEWRAPHULI, BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||