Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06017 | Date 31/07/2019 |
| Token No | SM/19-20/7659 31/07/2019 | Serial | 015 Last Visit: 31/07/2019 |
| Patient Name | Mrs. CHOTU SINGH | Contact No | |
| Address | RAM KRISHNA ROAD BAIDYABATI(M) | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||