Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03633 | Date 18/02/2019 |
| Token No | SM/18-19/10099 07/03/2019 | Serial | 102 Last Visit: 27/03/2019 |
| Patient Name | Mrs. PARUL HALDAR | Contact No | |
| Address | TETULTALA,BAGER BAGAN,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||