Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03235 | Date 30/01/2019 |
| Token No | SM/21-22/3599 29/07/2021 | Serial | 002 Last Visit: 10/05/2022 |
| Patient Name | Mrs. JHARNA DAS | Contact No | 9674416198 |
| Address | CHATRA G. T ROAD JAL TANK BAIDYABATI (M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||