Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04042 | Date 06/03/2019 |
| Token No | SM/18-19/9978 06/03/2019 | Serial | 068 Last Visit: 06/03/2019 |
| Patient Name | Mrs. SUMITRA BISWAS | Contact No | 7003131791 |
| Address | GT ROAD MANIK GHOSER BAGAN, BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||