Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01853 | Date 02/11/2018 |
| Token No | SM/18-19/6198 03/01/2019 | Serial | 035 Last Visit: 03/01/2019 |
| Patient Name | Mrs. TUKTUKI MONDAL | Contact No | 9088424864 |
| Address | 149, CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||