Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02696 | Date 27/12/2018 |
| Token No | SM/18-19/5798 27/12/2018 | Serial | 056 Last Visit: 27/12/2018 |
| Patient Name | Mrs. KATYANI PAL | Contact No | |
| Address | CAHTRA BAGER BAGAN ,BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||