Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04106 | Date 09/03/2019 |
| Token No | SM/18-19/10214 09/03/2019 | Serial | 005 Last Visit: 11/03/2019 |
| Patient Name | Mrs. SEFALI PAL | Contact No | 8697363379 |
| Address | CHATRA BOU BAJAR TELI PARA , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||