Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03653 | Date 18/02/2019 |
| Token No | SM/18-19/8902 18/02/2019 | Serial | 075 Last Visit: 18/02/2019 |
| Patient Name | Mrs. SUPARNA PAL | Contact No | 9748302830 |
| Address | 71/1A CHATRA TELI PARA, BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||