Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07396 | Date 22/01/2020 |
| Token No | SM/19-20/17030 22/01/2020 | Serial | 011 Last Visit: 22/01/2020 |
| Patient Name | Mrs. JHUMA DAS | Contact No | 9339205200 |
| Address | 19 NABIN CHAKRABORTY LANE CHATRA , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||