Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06222 | Date 26/08/2019 |
| Token No | SM/19-20/9134 26/08/2019 | Serial | 050 Last Visit: 31/08/2019 |
| Patient Name | Mrs. ASTHI DAS | Contact No | 8335863679 |
| Address | CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||