Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00402 | Date 13/08/2018 |
| Token No | SM/19-20/6420 13/07/2019 | Serial | 084 Last Visit: 14/11/2019 |
| Patient Name | Mrs. BHARATI GUPTA | Contact No | 9836798947 |
| Address | 96/E, G.T ROAD CHATRA , BAIDYABATI(M) | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||