Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05855 | Date 19/07/2019 |
| Token No | SM/19-20/9858 06/09/2019 | Serial | 023 Last Visit: 23/11/2019 |
| Patient Name | Mrs. JAYASREE SAHA | Contact No | 9804537502 |
| Address | E. S. I 4 COLONI | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||