Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04005 | Date 05/03/2019 |
| Token No | SM/18-19/10459 12/03/2019 | Serial | 050 Last Visit: 12/03/2019 |
| Patient Name | Mrs. MUMPI DAS | Contact No | 8017547353 |
| Address | RAMKRISHNA NAGAR , BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||