Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00913 | Date 04/09/2018 |
| Token No | SM/19-20/18225 17/02/2020 | Serial | 049 Last Visit: 23/05/2022 |
| Patient Name | Mrs. LAKHI DAS | Contact No | 9330637947 |
| Address | BOU BAJAR TELI PARA, BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||