Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05360 | Date 08/06/2019 |
| Token No | SM/19-20/15712 21/12/2019 | Serial | 020 Last Visit: 09/05/2020 |
| Patient Name | Mrs. SURABI PAL | Contact No | 7059677180 |
| Address | CHATRA TETUL TALA, BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||