Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03360 | Date 04/02/2019 |
| Token No | SM/21-22/7643 10/12/2021 | Serial | 006 Last Visit: 11/05/2023 |
| Patient Name | Mrs. KALPANA DAS | Contact No | 9163566934 |
| Address | 301J/A/E CHATRA,BAGER 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 | |||