Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05940 | Date 24/07/2019 |
| Token No | SM/19-20/7239 24/07/2019 | Serial | 081 Last Visit: 24/07/2019 |
| Patient Name | Mrs. RIYA DAS | Contact No | 9073202252 |
| Address | CHATRA BAGER BAGAN, BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||