Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04303 | Date 19/03/2019 |
| Token No | SM/18-19/10875 19/03/2019 | Serial | 068 Last Visit: 19/03/2019 |
| Patient Name | Mrs. MANJU MAITY | Contact No | 9088580443 |
| Address | 297 GT ROAD CHATRA MANSA TALA , BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||