Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09187 | Date 19/01/2021 |
| Token No | SM/20-21/30063 03/02/2021 | Serial | 015 Last Visit: 03/02/2021 |
| Patient Name | Mrs. KANCHAN SAH | Contact No | 8100251037 |
| Address | 254 RAMKRISHNA ROAD BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||