Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07623 | Date 24/02/2020 |
| Token No | SM/19-20/18590 24/02/2020 | Serial | 066 Last Visit: 24/02/2020 |
| Patient Name | Mrs. SHYAMALI ADAK | Contact No | 7278469861 |
| Address | MARADAN G T ROAD , BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||