Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03537 | Date 13/02/2019 |
| Token No | SM/18-19/8556 13/02/2019 | Serial | 023 Last Visit: 13/02/2019 |
| Patient Name | Mrs. CHITALI MAITY | Contact No | 8420796911 |
| Address | 19,CHATRA MUKHERJEE PARA,HARISOBHA,BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||