Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08156 | Date 27/04/2020 |
| Token No | SM/19-20/21713 29/04/2020 | Serial | 032 Last Visit: 29/04/2020 |
| Patient Name | Mrs. PHALGUNI MAJHI | Contact No | 9007622342 |
| Address | 57/G/D/A/C G T ROAD PAMPA NAGAR BAIDYABATI M | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||