Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05367 | Date 10/06/2019 |
| Token No | SM/19-20/5618 29/06/2019 | Serial | 051 Last Visit: 15/07/2019 |
| Patient Name | Mrs. KABITA GIRI | Contact No | 8582889856 |
| Address | 62/D GHOSAL PARA NABAGRAM BAIDYABATI(M) MALLICKPARA | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||