Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04086 | Date 08/03/2019 |
| Token No | SM/18-19/10138 08/03/2019 | Serial | 029 Last Visit: 11/06/2019 |
| Patient Name | Mrs. SIBANI NATH | Contact No | 8481919200 |
| Address | 76/1 TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 23 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||