Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07492 | Date 07/02/2020 |
| Token No | SM/19-20/18197 17/02/2020 | Serial | 021 Last Visit: 16/06/2020 |
| Patient Name | Mrs. CHAMPA RUIDAS | Contact No | 7449357961 |
| Address | GOSAIPARA,CHAKRABORTY PARA | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||