Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03598 | Date 15/02/2019 |
| Token No | SM/18-19/8752 15/02/2019 | Serial | 040 Last Visit: 15/02/2019 |
| Patient Name | Mrs. JAYANTI BHUNIA | Contact No | 7059085383 |
| Address | 512/333 CHATA JOLTANK,BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||