Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04121 | Date 09/03/2019 |
| Token No | SM/18-19/10258 09/03/2019 | Serial | 049 Last Visit: 09/03/2019 |
| Patient Name | Mrs. MAMPI DAS | Contact No | 6290426758 |
| Address | CHATRA LANKAR BAGAN ,BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||