Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03986 | Date 05/03/2019 |
| Token No | SM/18-19/9802 05/03/2019 | Serial | 003 Last Visit: 03/09/2021 |
| Patient Name | Mrs. PONCHOBALA MONDAL | Contact No | 8420084457 |
| Address | SHITALA TALA JOL TANK | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||