Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08060 | Date 11/04/2020 |
| Token No | SM/19-20/22045 07/05/2020 | Serial | 033 Last Visit: 18/08/2020 |
| Patient Name | Mrs. KANAK RANI DAS | Contact No | 9007647159 |
| Address | 29 DR. BAGAN LANE | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||