Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03555 | Date 13/02/2019 |
| Token No | SM/18-19/10379 11/03/2019 | Serial | 088 Last Visit: 11/03/2019 |
| Patient Name | Mrs. LALITA BHADURI | Contact No | 8013835997 |
| Address | CHATRA BOUBAZAR,BAIDYABATI(M) | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||