Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01399 | Date 28/09/2018 |
| Token No | SM/18-19/2189 28/09/2018 | Serial | 018 Last Visit: 28/09/2018 |
| Patient Name | Mrs. TAPASI MONDAL | Contact No | 9088089987 |
| Address | 69 J/A G.T ROAD MORADAN , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||