Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05960 | Date 26/07/2019 |
| Token No | SM/19-20/7812 02/08/2019 | Serial | 044 Last Visit: 02/08/2019 |
| Patient Name | Mrs. BHARATI AHIR | Contact No | |
| Address | CHATARA MANIK GHOSER BAGAN, BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||