Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04410 | Date 27/03/2019 |
| Token No | SM/18-19/11300 27/03/2019 | Serial | 004 Last Visit: 01/04/2019 |
| Patient Name | Mrs. MINA MALLIK | Contact No | 9051575832 |
| Address | CHARA BAGAN BAURI PARA SHEWRAPHULI, BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||