Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05946 | Date 25/07/2019 |
| Token No | SM/19-20/7265 25/07/2019 | Serial | 018 Last Visit: 25/07/2019 |
| Patient Name | Mrs. PALLABI DAS | Contact No | 9088609969 |
| Address | 277/A TELI PARA LANE CHATRA BAIDYABATI(M) | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||