Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04458 | Date 29/03/2019 |
| Token No | SM/18-19/11511 29/03/2019 | Serial | 019 Last Visit: 29/03/2019 |
| Patient Name | Mrs. BASANTI HAZRA | Contact No | |
| Address | CHAK PURBA PARA RAM MOHAN SARANI , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||