Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06386 | Date 12/09/2019 |
| Token No | SM/19-20/11101 25/09/2019 | Serial | 043 Last Visit: 16/10/2019 |
| Patient Name | Mrs. MOUSUMI KAYAL | Contact No | 8240602892 |
| Address | TELIPARA BAGER BAGAN , CHINSURAH , BAIDYABATI(M) | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||