Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03001 | Date 14/01/2019 |
| Token No | SM/18-19/6789 14/01/2019 | Serial | 080 Last Visit: 11/04/2019 |
| Patient Name | Mrs. SUMITA PAL | Contact No | 9051316510 |
| Address | KHAR PARA KALITALA , BAIDYABATI (M) | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||