Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 08920 | Date 31/10/2020 |
| Token No | SM/20-21/27003 31/10/2020 | Serial | 012 Last Visit: 03/05/2023 |
| Patient Name | Mrs. KUMKUM CHOUDHURY | Contact No | 9674948730 |
| Address | PIYARAPUR ROAD CHATRA BAGAN BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||