Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02306 | Date 03/12/2018 |
| Token No | SM/18-19/4588 03/12/2018 | Serial | 054 Last Visit: 03/12/2018 |
| Patient Name | Mrs. ARATI SAMANTA | Contact No | 8282810639 |
| Address | (***BLOCKED)BAGER BAGAN TELIPARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||