Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04081 | Date 08/03/2019 |
| Token No | SM/18-19/10133 08/03/2019 | Serial | 024 Last Visit: 08/03/2019 |
| Patient Name | Mrs. REKHA GHOSH | Contact No | 9883065200 |
| Address | CHATRA MANNA PARA RAMKRISHNA ROAD, 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 | |||