Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04439 | Date 28/03/2019 |
| Token No | SM/18-19/11425 28/03/2019 | Serial | 027 Last Visit: 28/03/2019 |
| Patient Name | Mrs. JOGMAYA GOSWAMI | Contact No | |
| Address | MARADAN GODARA BAGAN , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||