Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07557 | Date 17/02/2020 |
| Token No | SM/19-20/18181 17/02/2020 | Serial | 005 Last Visit: 17/02/2020 |
| Patient Name | Mrs. MAMOTA SAMANTA | Contact No | 8479052484 |
| Address | 65 MUKHERJEE PARA CHATRA , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||