Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04641 | Date 09/04/2019 |
| Token No | SM/19-20/578 09/04/2019 | Serial | 032 Last Visit: 09/04/2019 |
| Patient Name | Mrs. RUPALI SHAW | Contact No | 9903130784 |
| Address | 107. RAM KRISHNA ROAD,CHATRA,BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||