Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07802 | Date 14/03/2020 |
| Token No | SM/19-20/19675 14/03/2020 | Serial | 078 Last Visit: 14/03/2020 |
| Patient Name | Mrs. SUSHUMA SARKAR | Contact No | 7029934991 |
| Address | 136 TELI PARA BAGER BAGAN CHATRA , BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||