Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02955 | Date 11/01/2019 |
| Token No | SM/18-19/6646 11/01/2019 | Serial | 003 Last Visit: 11/01/2019 |
| Patient Name | Mrs. MANJU HARI | Contact No | 9123838257 |
| Address | RAMKRISHNA NAGAR,BAURYA PARA,BAIDYABATY(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||