Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04940 | Date 27/04/2019 |
| Token No | SM/19-20/18098 14/02/2020 | Serial | 055 Last Visit: 14/02/2020 |
| Patient Name | Mrs. SUMANA DAS | Contact No | 9804700130 |
| Address | 3,HARIJAN ROAD BAIDYABATI(M) CHATRA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||