Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04455 | Date 29/03/2019 |
| Token No | SM/18-19/11494 29/03/2019 | Serial | 002 Last Visit: 29/03/2019 |
| Patient Name | Mrs. NAMITA MONDAL | Contact No | 8335863679 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||