Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 06529 | Date 24/09/2019 |
| Token No | SM/19-20/11011 24/09/2019 | Serial | 029 Last Visit: 24/09/2019 |
| Patient Name | Mrs. BASANTI CHAKRABORTY | Contact No | 9088474233 |
| Address | MIRPARA, SHANKARPALLY BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||