Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03235 | Date 30/01/2019 |
| Token No | SM/19-20/2426 10/05/2019 | Serial | 023 Last Visit: 10/05/2022 |
| Patient Name | Mrs. JHARNA DAS | Contact No | 9674416198 |
| Address | CHATRA G. T ROAD JAL TANK BAIDYABATI (M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||