Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03376 | Date 05/02/2019 |
| Token No | SM/19-20/2633 13/05/2019 | Serial | 044 Last Visit: 27/01/2022 |
| Patient Name | Mrs. SUSHAMA DAS | Contact No | 8443839661 |
| Address | SATCHASI PARA,LANKER BAGAN,BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||