Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04669 | Date 11/04/2019 |
| Token No | SM/19-20/732 11/04/2019 | Serial | 039 Last Visit: 11/04/2019 |
| Patient Name | Miss MAMUNI DEB NATH | Contact No | |
| Address | 515 GT ROAD CHATRA , BAIDYABATI(M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||