Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09108 | Date 29/12/2020 |
| Token No | SM/20-21/28884 29/12/2020 | Serial | 028 Last Visit: 29/12/2020 |
| Patient Name | Mrs. TUMPA MONDAL | Contact No | 8100742729 |
| Address | 196/1 G T ROAD CHATRA BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||