Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05544 | Date 24/06/2019 |
| Token No | SM/19-20/5205 24/06/2019 | Serial | 071 Last Visit: 24/06/2019 |
| Patient Name | Mrs. SABONI BYADA | Contact No | 7449938496 |
| Address | PAMPANAGAR CHATRA,BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||