Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04364 | Date 25/03/2019 |
| Token No | SM/18-19/11123 25/03/2019 | Serial | 043 Last Visit: 25/03/2019 |
| Patient Name | Mrs. SANDHA PAL | Contact No | 7044340599 |
| Address | 129, CHATRA SHITLATALA ROAD , BAIDYABATI (M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||