Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03999 | Date 05/03/2019 |
| Token No | SM/18-19/10227 09/03/2019 | Serial | 018 Last Visit: 09/03/2019 |
| Patient Name | Mrs. SOMA MONDAL | Contact No | 8582911216 |
| Address | RAMKRISHANA NAGAR, BAIDYABATI(M) | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||