Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03107 | Date 21/01/2019 |
| Token No | SM/19-20/6508 15/07/2019 | Serial | 051 Last Visit: 03/06/2022 |
| Patient Name | Mrs. MALINA BERA | Contact No | 9831510769 |
| Address | 209/B TELI PARA BAGER BAGAN CHATRA, BAIDYABATI (M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||