Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04890 | Date 24/04/2019 |
| Token No | SM/19-20/1564 24/04/2019 | Serial | 034 Last Visit: 28/01/2022 |
| Patient Name | Mrs. CHAYA PAL | Contact No | 9051362114 |
| Address | 301/T/C CHATRA BAGER BAGAN SHITLATALA , BAIYABATI(M) | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||