Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03896 | Date 27/02/2019 |
| Token No | SM/18-19/9550 27/02/2019 | Serial | 039 Last Visit: 10/08/2019 |
| Patient Name | Mrs. SUMITRA SHA | Contact No | 7890390358 |
| Address | 8/6 CHATRA SHITLATALA, BAIDYABATI(M) | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||