Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04668 | Date 11/04/2019 |
| Token No | SM/19-20/731 11/04/2019 | Serial | 038 Last Visit: 11/04/2019 |
| Patient Name | Mrs. JHARNA DEB NATHA | Contact No | |
| Address | 515 GT ROAD CHATRA , BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||