Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06692 | Date 19/10/2019 |
| Token No | SM/19-20/16060 31/12/2019 | Serial | 002 Last Visit: 29/02/2020 |
| Patient Name | Mrs. ARATI DEVI ROUTH | Contact No | 7890242213 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||