Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04284 | Date 18/03/2019 |
| Token No | SM/18-19/10859 19/03/2019 | Serial | 052 Last Visit: 19/03/2019 |
| Patient Name | Mrs. ANITA SARKAR | Contact No | 8481040001 |
| Address | CHATRA SHITLATALA K.C MUKHERJEE STREET, BAIDYABATI(M) | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||