Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04226 | Date 15/03/2019 |
| Token No | SM/18-19/10575 15/03/2019 | Serial | 068 Last Visit: 13/06/2019 |
| Patient Name | Miss YASMIN KHATUN | Contact No | 6290779799 |
| Address | PAMPA NAGAR TETUL TALA , BAIDYABATI(M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||