Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06320 | Date 03/09/2019 |
| Token No | SM/19-20/9712 03/09/2019 | Serial | 023 Last Visit: 13/09/2019 |
| Patient Name | Mrs. MAYA BANIK | Contact No | 9062932050 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYBATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||