Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02848 | Date 07/01/2019 |
| Token No | SM/18-19/6669 11/01/2019 | Serial | 026 Last Visit: 11/01/2019 |
| Patient Name | Mrs. KAMLABALA MONDAL | Contact No | 9875500316 |
| Address | SHEWRAPHULI CHARA BAGAN BARUI PARA , BAIDYABATI(M) | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||