Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04207 | Date 15/03/2019 |
| Token No | SM/18-19/10527 15/03/2019 | Serial | 020 Last Visit: 24/07/2019 |
| Patient Name | Mrs. MAYA GHOSH | Contact No | 9044682369 |
| Address | CHATRA BAGER BAGAN TELI PARA | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||