Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03585 | Date 14/02/2019 |
| Token No | SM/18-19/8695 14/02/2019 | Serial | 060 Last Visit: 14/02/2019 |
| Patient Name | Mrs. GITA GHARA | Contact No | 8420658386 |
| Address | CHATRA MUKHERJEE PARA,HORISOBHA,BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||