Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04350 | Date 23/03/2019 |
| Token No | SM/18-19/11059 23/03/2019 | Serial | 063 Last Visit: 26/08/2019 |
| Patient Name | Mrs. RADHA BHADRA | Contact No | |
| Address | CHATRA LANKAR BAGAN, BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||