Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04926 | Date 26/04/2019 |
| Token No | SM/19-20/1724 26/04/2019 | Serial | 036 Last Visit: 26/04/2019 |
| Patient Name | Mrs. SANDHYA KOLEY | Contact No | 9433335391 |
| Address | RAMKRISHNA NAGAR SAN PUKUR DHAR, BAIDYABTI(M) | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||