Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07234 | Date 27/12/2019 |
| Token No | SM/19-20/16681 14/01/2020 | Serial | 010 Last Visit: 22/12/2020 |
| Patient Name | Mrs. BULA ADGIRI | Contact No | 7890242207 |
| Address | 320/486 G.T ROAD , BAIDYABATI(M) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||