Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04385 | Date 26/03/2019 |
| Token No | SM/18-19/11213 26/03/2019 | Serial | 006 Last Visit: 18/04/2019 |
| Patient Name | Mrs. SANDHYA DAS | Contact No | 8017164009 |
| Address | 502 GT ROAD CHATRA SERAMPORE , BAIDYABATI(M) | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||