Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06868 | Date 15/11/2019 |
| Token No | SM/19-20/21645 27/04/2020 | Serial | 072 Last Visit: 27/04/2020 |
| Patient Name | Mrs. NIVA DAS | Contact No | 8013074369 |
| Address | 95/7/CN CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||