Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01194 | Date 18/09/2018 |
| Token No | SM/18-19/8927 18/02/2019 | Serial | 100 Last Visit: 23/02/2022 |
| Patient Name | Mrs. KALPANA PAL | Contact No | 9674048525 |
| Address | 23 CHATRA TETULTALA BAZAR,BAIDYABATI(M) | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||