Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02443 | Date 10/12/2018 |
| Token No | SM/18-19/4988 10/12/2018 | Serial | 036 Last Visit: 10/12/2018 |
| Patient Name | Mrs. SANGITA BENERJEE DAS | Contact No | 9933913707 |
| Address | CHATRA MANNA PARA,BAIDAYBATY (M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||