Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05633 | Date 02/07/2019 |
| Token No | SM/19-20/5712 02/07/2019 | Serial | 002 Last Visit: 01/03/2021 |
| Patient Name | Mrs. PURNIMA MANNA | Contact No | 8420204916 |
| Address | 92 BARUEPARA BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||