Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09099 | Date 26/12/2020 |
| Token No | SM/20-21/28782 26/12/2020 | Serial | 018 Last Visit: 26/12/2020 |
| Patient Name | Mrs. SARSWATI DUTTA | Contact No | 8017088135 |
| Address | 79 (39/I) TENULTALA CHATRA, BAIDYABATI(M) | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||