Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02132 | Date 26/11/2018 |
| Token No | SM/18-19/4175 26/11/2018 | Serial | 048 Last Visit: 26/11/2018 |
| Patient Name | Miss AMRITA PRAMANICK | Contact No | 9681491270 |
| Address | 105A/H CHATRA GHOSER BAGAN,BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||