Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04140 | Date 11/03/2019 |
| Token No | SM/18-19/10300 11/03/2019 | Serial | 009 Last Visit: 11/03/2019 |
| Patient Name | Mrs. MINATI GUPTA | Contact No | 8420084457 |
| Address | SHITLATALA JOL TANK, BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||