Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08002 | Date 02/04/2020 |
| Token No | SM/21-22/3735 04/08/2021 | Serial | 002 Last Visit: 04/08/2021 |
| Patient Name | Miss SARUPA MAITY | Contact No | 8617783820 |
| Address | 42(36/D/D)G.T. ROAD,TETULTALA,BAIDYABATI(M) | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||