Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05271 | Date 28/05/2019 |
| Token No | SM/19-20/3590 28/05/2019 | Serial | 031 Last Visit: 13/02/2020 |
| Patient Name | Mrs. SUPARNA SANTRA (PARUI) | Contact No | 7450064959 |
| Address | 104 3 NO. LAHANAGAR COLONY , BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||