Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07670 | Date 28/02/2020 |
| Token No | SM/19-20/21414 21/04/2020 | Serial | 026 Last Visit: 21/04/2020 |
| Patient Name | Mrs. MAMATA MANNA | Contact No | |
| Address | 105/B/4 G. T. ROAD,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||