Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05022 | Date 07/05/2019 |
| Token No | SM/19-20/2235 07/05/2019 | Serial | 016 Last Visit: 07/05/2019 |
| Patient Name | Mrs. KABITA MISHRA | Contact No | 9007420947 |
| Address | 11/M, G.T ROAD MANIK GHOSER BAGAN , BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||