Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06525 | Date 24/09/2019 |
| Token No | SM/19-20/18249 17/02/2020 | Serial | 073 Last Visit: 23/05/2020 |
| Patient Name | Mrs. PUSHPA DAS | Contact No | 9051545615 |
| Address | 51/A, SHITALALA ROAD,BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||