Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04618 | Date 08/04/2019 |
| Token No | SM/19-20/3175 22/05/2019 | Serial | 016 Last Visit: 29/06/2022 |
| Patient Name | Mrs. LAKSHMI RUI DAS | Contact No | 8820942627 |
| Address | 10 CHATRA DAS PARA,BAIDYABATI(M) | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||