Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06166 | Date 20/08/2019 |
| Token No | SM/19-20/8778 20/08/2019 | Serial | 057 Last Visit: 20/08/2019 |
| Patient Name | Mrs. MITHU BERA | Contact No | 8017570295 |
| Address | 209/B CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||