Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07869 | Date 20/03/2020 |
| Token No | SM/19-20/20429 28/03/2020 | Serial | 016 Last Visit: 28/03/2020 |
| Patient Name | Mrs. KABITA DAS (PANJA) | Contact No | 9681213181 |
| Address | G. T. ROAD,TELIPARA,BAGHER BAGAN,BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||