Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06683 | Date 18/10/2019 |
| Token No | SM/19-20/15886 26/12/2019 | Serial | 017 Last Visit: 06/05/2020 |
| Patient Name | Mrs. CHABI SENAPATI | Contact No | 8017820141 |
| Address | 40(34/2) MUKHERJEE PARA, CHATRA SERAMPORE | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||