Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03908 | Date 28/02/2019 |
| Token No | SM/18-19/9593 28/02/2019 | Serial | 015 Last Visit: 28/02/2019 |
| Patient Name | Mrs. SOBHA DAS | Contact No | 9836936152 |
| Address | CHATRA BOUBAZAR,TELI PARA,BAIDYABATI(M) | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||