Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05477 | Date 18/06/2019 |
| Token No | SM/19-20/4822 18/06/2019 | Serial | 080 Last Visit: 18/06/2019 |
| Patient Name | Mrs. MALINA MAHATO | Contact No | 6289969027 |
| Address | 10/A/Z/Z G.T ROAD PAMPANAGAR, BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||