Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06812 | Date 07/11/2019 |
| Token No | SM/19-20/17073 22/01/2020 | Serial | 054 Last Visit: 22/01/2020 |
| Patient Name | Miss NEHA DAS | Contact No | 9681931323 |
| Address | 301/J/E/A, TELIPARA, CHATRA , BAIDYABATI M | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||