Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03251 | Date 31/01/2019 |
| Token No | SM/18-19/7670 31/01/2019 | Serial | 044 Last Visit: 31/01/2019 |
| Patient Name | Mrs. SONALI DAS | Contact No | 9088160136 |
| Address | CHATRA BAGHER BAGAN,BAIDYABATY(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||