Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04398 | Date 26/03/2019 |
| Token No | SM/18-19/11250 26/03/2019 | Serial | 043 Last Visit: 11/04/2019 |
| Patient Name | Mrs. SANGITA BURNWAL | Contact No | 8981490952 |
| Address | CHATRA TELI PARA BAGER BAGAN , BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||