Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08999 | Date 26/11/2020 |
| Token No | SM/20-21/27833 26/11/2020 | Serial | 034 Last Visit: 26/11/2020 |
| Patient Name | Mrs. RENU DEVI SHAW | Contact No | 9804902755 |
| Address | TELIPARA BAGER BAGAN CHATRA , BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||