Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03369 | Date 05/02/2019 |
| Token No | SM/18-19/8012 05/02/2019 | Serial | 003 Last Visit: 02/04/2019 |
| Patient Name | Mrs. PUSHPA MANDOL | Contact No | 6289110727 |
| Address | RAMKRISHNA NAGER,SAN PIRIR MAT,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||