Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04434 | Date 28/03/2019 |
| Token No | SM/18-19/11409 28/03/2019 | Serial | 011 Last Visit: 29/03/2019 |
| Patient Name | Mrs. FALGUNI GHARA DAS | Contact No | 9830604468 |
| Address | 30/32 CHATRA MUKHERJEE PARA , BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||