Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00801 | Date 29/08/2018 |
| Token No | SM/19-20/7533 29/07/2019 | Serial | 069 Last Visit: 10/05/2022 |
| Patient Name | Mrs. JHUMA GHORUI | Contact No | 8583026025 |
| Address | CHATRA BAGHER BAGAN | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||