Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02024 | Date 19/11/2018 |
| Token No | SM/18-19/3859 19/11/2018 | Serial | 026 Last Visit: 20/11/2018 |
| Patient Name | Mrs. TILOKA MONDAL | Contact No | 9674151783 |
| Address | NOGA , PAMPA NAGARM, BAIDYABATI (M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||