Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03026 | Date 16/01/2019 |
| Token No | SM/18-19/6893 16/01/2019 | Serial | 039 Last Visit: 16/03/2022 |
| Patient Name | Mrs. GITA DAS | Contact No | 9836232595 |
| Address | 151/C TELIPARA BAGER BAGAN CHATRA SERAMPORE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||