Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03670 | Date 18/02/2019 |
| Token No | SM/18-19/8934 18/02/2019 | Serial | 107 Last Visit: 18/02/2019 |
| Patient Name | Mrs. KRIHSNA MALIK | Contact No | 9681230435 |
| Address | 189/47 SHITLATALA ROAD CHATRA BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||