Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03660 | Date 18/02/2019 |
| Token No | SM/19-20/10772 20/09/2019 | Serial | 063 Last Visit: 23/04/2020 |
| Patient Name | Mrs. BASMATI ROUTH | Contact No | 9883240077 |
| Address | BAGER BAGAN TELI PARA, BAIDYABATI (M) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||