Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09345 | Date 19/03/2021 |
| Token No | SM/20-21/31326 31/03/2021 | Serial | 010 Last Visit: 01/10/2021 |
| Patient Name | Mrs. BHARATI JANA | Contact No | 9143704392 |
| Address | 45 G.T. ROAD BAIDYABATI M | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||