Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00456 | Date 14/08/2018 |
| Token No | SM/18-19/6502 08/01/2019 | Serial | 056 Last Visit: 05/08/2021 |
| Patient Name | Mrs. TARA MONDAL | Contact No | 9163457883 |
| Address | CHATRA BAGER BAGAN BAIDYABATI (M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||