Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04584 | Date 06/04/2019 |
| Token No | SM/19-20/375 06/04/2019 | Serial | 003 Last Visit: 05/07/2019 |
| Patient Name | Mrs. SOMA BEGAM | Contact No | 9073124212 |
| Address | CHATRA BAURIYA PARA , BAIDYABATI(M) | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||