Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07129 | Date 12/12/2019 |
| Token No | SM/19-20/15670 20/12/2019 | Serial | 039 Last Visit: 20/12/2019 |
| Patient Name | Mrs. SUDHA MAJHI | Contact No | 7044768918 |
| Address | 57/A/J/O GODAR BAGAN BYE LANE , BAIDYABATI(M) | Age | 74 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||