Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08133 | Date 23/04/2020 |
| Token No | SM/19-20/21472 23/04/2020 | Serial | 019 Last Visit: 27/04/2020 |
| Patient Name | Mrs. ANITA DAS GUPTA | Contact No | 7980235271 |
| Address | KOLNATH VILLA,175B/J/A R. K. ROAD,CHATRA,BAIDYABATI(M) | Age | 32 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||