Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06911 | Date 19/11/2019 |
| Token No | SM/19-20/20351 26/03/2020 | Serial | 063 Last Visit: 17/04/2020 |
| Patient Name | Mrs. USHA SAHA | Contact No | 6290954970 |
| Address | CHATRA BAGER BAGAN TELI PARA | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||