Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01858 | Date 02/11/2018 |
| Token No | SM/18-19/3350 02/11/2018 | Serial | 034 Last Visit: 02/11/2018 |
| Patient Name | Mrs. SHEFALI MONDAL | Contact No | 8481938721 |
| Address | CHATRA BAGER BAGAN , BAIDYABATI(M) | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||