Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03074 | Date 18/01/2019 |
| Token No | SM/18-19/8160 06/02/2019 | Serial | 054 Last Visit: 06/02/2019 |
| Patient Name | Mrs. SIKHA KOLEY | Contact No | |
| Address | MANNA PARA , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||