Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02798 | Date 03/01/2019 |
| Token No | SM/18-19/9143 21/02/2019 | Serial | 005 Last Visit: 21/02/2019 |
| Patient Name | Mrs. ANNWESHA DAS | Contact No | 6291618734 |
| Address | CHATUGANJ SHEWRAPHULI, BAIDYABATI(M) | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||