Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04865 | Date 23/04/2019 |
| Token No | SM/21-22/2779 02/07/2021 | Serial | 052 Last Visit: 17/07/2021 |
| Patient Name | Mrs. JYOTSNA DAS | Contact No | 9051784557 |
| Address | SACHTASHI PARA CHATRA LANKAR BAGAN, BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||