Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04058 | Date 07/03/2019 |
| Token No | SM/18-19/10059 07/03/2019 | Serial | 062 Last Visit: 07/03/2019 |
| Patient Name | Mrs. TANUSHREE MONDAL | Contact No | 7890214339 |
| Address | 59 GT ROAD CHATRA TETUL TALA , BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||