Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04251 | Date 16/03/2019 |
| Token No | SM/18-19/10649 16/03/2019 | Serial | 031 Last Visit: 16/03/2019 |
| Patient Name | Mrs. MAMTA MONDAL | Contact No | 7687933307 |
| Address | 109/299 CHATRA PATTI PARA , BAIDYABATI(M) | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||