Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04141 | Date 11/03/2019 |
| Token No | SM/18-19/10305 11/03/2019 | Serial | 014 Last Visit: 11/03/2019 |
| Patient Name | Mrs. PURNIMA GHOSH | Contact No | 8334877854 |
| Address | 306 PASCHIM MANNA CHATRA , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||