Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03584 | Date 14/02/2019 |
| Token No | SM/18-19/8694 14/02/2019 | Serial | 059 Last Visit: 19/02/2020 |
| Patient Name | Mrs. DOLLY NANDI | Contact No | 9163676463 |
| Address | 63/23A HARIJON ROAD,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||