Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06431 | Date 16/09/2019 |
| Token No | SM/19-20/10485 16/09/2019 | Serial | 086 Last Visit: 16/09/2019 |
| Patient Name | Mrs. SAMPA DUTTA | Contact No | 8777565612 |
| Address | 287 CHARABAGAN BAUREPARA , BAIDYABATI(M) | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||