Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08112 | Date 20/04/2020 |
| Token No | SM/19-20/21717 30/04/2020 | Serial | 001 Last Visit: 30/04/2020 |
| Patient Name | Mrs. BHARATI RUI DAS | Contact No | |
| Address | 28 BAGER BAGAN,TELI PARA,BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||