Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06652 | Date 16/10/2019 |
| Token No | SM/19-20/21441 22/04/2020 | Serial | 024 Last Visit: 22/04/2020 |
| Patient Name | Mrs. SABITA NANDI | Contact No | 9230128638 |
| Address | 78, TELI PARA CHATRA , BAIDYBATI(M) | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||