Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09092 | Date 24/12/2020 |
| Token No | SM/20-21/28735 24/12/2020 | Serial | 018 Last Visit: 06/05/2021 |
| Patient Name | Mrs. SUJATA PAUL | Contact No | 9051063324 |
| Address | 146, G T ROAD BOWBAZAR, BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||