Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04274 | Date 18/03/2019 |
| Token No | SM/18-19/11308 27/03/2019 | Serial | 012 Last Visit: 10/04/2019 |
| Patient Name | Mrs. TULU DAS | Contact No | 9874948184 |
| Address | CHATRA BAGER BAGN TELI PARA , BAIDYABATI(M) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||