Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03774 | Date 21/02/2019 |
| Token No | SM/18-19/9425 25/02/2019 | Serial | 032 Last Visit: 25/02/2019 |
| Patient Name | Mrs. ITI KUNDU BHOWMIK | Contact No | 9836475826 |
| Address | 176 NS ROAD SHEWRAPHULI, BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||