Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06096 | Date 09/08/2019 |
| Token No | SM/19-20/8258 09/08/2019 | Serial | 065 Last Visit: 22/08/2019 |
| Patient Name | Mrs. MANJU DHEKI | Contact No | 9143308047 |
| Address | 64(26) CHATRA LANKAR BAGAN SACHTASHI PARA , BAIDYBATI (M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||