Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04323 | Date 20/03/2019 |
| Token No | SM/18-19/10954 20/03/2019 | Serial | 059 Last Visit: 20/03/2019 |
| Patient Name | Mrs. SOMA DAS | Contact No | 9836702922 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||