Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08662 | Date 24/08/2020 |
| Token No | SM/19-20/25438 04/09/2020 | Serial | 009 Last Visit: 13/10/2020 |
| Patient Name | Mrs. DIPA DAS | Contact No | 9875458554 |
| Address | 34 PATIPARA,BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||