Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00503 | Date 17/08/2018 |
| Token No | SM/18-19/4823 07/12/2018 | Serial | 017 Last Visit: 02/12/2019 |
| Patient Name | Mrs. BIJALI BHADRA | Contact No | 7686950910 |
| Address | MANIK GHOSER BAGAN , BAIDYABATI (M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||