Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06989 | Date 26/11/2019 |
| Token No | SM/19-20/19764 17/03/2020 | Serial | 023 Last Visit: 12/06/2020 |
| Patient Name | Mrs. MAYA MAJHI | Contact No | 9804109138 |
| Address | 59 BARA BAGAN LANE SERAMPORE MALLICK PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||