Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03882 | Date 26/02/2019 |
| Token No | SM/19-20/10846 21/09/2019 | Serial | 055 Last Visit: 21/09/2019 |
| Patient Name | Mrs. TUMPA MODAK | Contact No | 7044695770 |
| Address | RAMKRISHANA NAGAR , BAIDYABATI(M) | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||