Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07956 | Date 30/03/2020 |
| Token No | SM/19-20/20452 30/03/2020 | Serial | 003 Last Visit: 30/03/2020 |
| Patient Name | Mrs. SHEPHALI DAS | Contact No | 7688016671 |
| Address | 171(73/E) TELI PARA BAGER BAGAN CHATRA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||