Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03215 | Date 29/01/2019 |
| Token No | SM/20-21/29980 01/02/2021 | Serial | 044 Last Visit: 04/05/2021 |
| Patient Name | Mrs. MINA MAHATO | Contact No | 7278851066 |
| Address | 55/1 SATCHASHI PARA , BAIDYABATI (M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||