Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04132 | Date 09/03/2019 |
| Token No | SM/19-20/6805 18/07/2019 | Serial | 080 Last Visit: 18/07/2019 |
| Patient Name | Mrs. KABITA MAJHI | Contact No | 8420962913 |
| Address | 362/1A CHATRA PAN PARA , BAIDYABATI (M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||