Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07625 | Date 25/02/2020 |
| Token No | SM/19-20/18614 25/02/2020 | Serial | 014 Last Visit: 25/02/2020 |
| Patient Name | Mrs. GOLAPI BISAYEE | Contact No | 9903275728 |
| Address | 79 MUKHERJEE PARA,CHATRA,BAIDYABATI(M) | Age | 37 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||