Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03137 | Date 22/01/2019 |
| Token No | SM/18-19/9203 21/02/2019 | Serial | 065 Last Visit: 21/02/2019 |
| Patient Name | Mrs. MINATI SOM | Contact No | 9681524860 |
| Address | 79CHATRA SHETOLATALA ,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||