Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04079 | Date 08/03/2019 |
| Token No | SM/18-19/10124 08/03/2019 | Serial | 015 Last Visit: 08/04/2019 |
| Patient Name | Mrs. ARATI DAS | Contact No | 8777019565 |
| Address | CHATRA MANNA PARA , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||