Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02085 | Date 22/11/2018 |
| Token No | SM/18-19/4899 08/12/2018 | Serial | 026 Last Visit: 08/12/2018 |
| Patient Name | Mrs. SHILA PRAMNICK | Contact No | 9830289833 |
| Address | 95/38 A/A CHATRA TETUL TALA , BAIDYABATI (M) | Age | 40 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||