Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03909 | Date 28/02/2019 |
| Token No | SM/18-19/9600 28/02/2019 | Serial | 022 Last Visit: 11/04/2019 |
| Patient Name | Mrs. MANJU DAS | Contact No | 8582911244 |
| Address | NAOGAR BAZAR,BAIDYABATI(M) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||