Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02807 | Date 03/01/2019 |
| Token No | SM/18-19/7700 31/01/2019 | Serial | 074 Last Visit: 02/12/2019 |
| Patient Name | Mrs. PUTUL BIBI | Contact No | 9007756219 |
| Address | CHATRA MUSALMAN PARA BYE LANE , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||