Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05390 | Date 11/06/2019 |
| Token No | SM/19-20/11170 26/09/2019 | Serial | 054 Last Visit: 08/02/2020 |
| Patient Name | Mrs. KAKULI GUIN | Contact No | 9433360227 |
| Address | 7 CHATRA GODAR BAGAN , BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||