Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03212 | Date 29/01/2019 |
| Token No | SM/18-19/10842 19/03/2019 | Serial | 035 Last Visit: 16/07/2019 |
| Patient Name | Mrs. RITA DAS | Contact No | 8276953051 |
| Address | 61 GOALA PARA LANE,BOWBAZER BAIDYABATI (M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||