Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04311 | Date 20/03/2019 |
| Token No | SM/18-19/11066 23/03/2019 | Serial | 070 Last Visit: 10/04/2019 |
| Patient Name | Mrs. SHRABANTI DAS | Contact No | 9051362105 |
| Address | PIYARAPUR PURBA PARA SHEWRAPHULI , BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||