Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05684 | Date 06/07/2019 |
| Token No | SM/19-20/6258 11/07/2019 | Serial | 008 Last Visit: 15/07/2019 |
| Patient Name | Mrs. BANHI SIKHA BARIK | Contact No | 9748731948 |
| Address | 45 CHATRA LANKAR BAGAN SERAMPORE, BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 90 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||