Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03442 | Date 07/02/2019 |
| Token No | SM/18-19/8250 07/02/2019 | Serial | 077 Last Visit: 07/02/2019 |
| Patient Name | Mrs. SARMISTHA SAMANTA | Contact No | 8697904219 |
| Address | CHATRA GODER BAGAN,BAIDYABATI(M) | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||