Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06302 | Date 02/09/2019 |
| Token No | SM/19-20/10742 20/09/2019 | Serial | 033 Last Visit: 01/10/2019 |
| Patient Name | Mrs. SANDHYA RANI PAUL | Contact No | 9143254453 |
| Address | 112 (32/A/P) G.T ROAD MARADAN, BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||