Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03789 | Date 22/02/2019 |
| Token No | SM/18-19/9723 02/03/2019 | Serial | 042 Last Visit: 02/03/2019 |
| Patient Name | Mrs. MOUSUMI SAHA | Contact No | 9903186815 |
| Address | CHATRA MANNA PARA HARIJAN ROAD, BAIDYABATI(M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||