Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06561 | Date 27/09/2019 |
| Token No | SM/19-20/11230 27/09/2019 | Serial | 041 Last Visit: 14/10/2019 |
| Patient Name | Mrs. ASHAJYOTI HALDER SAHA | Contact No | 9748367537 |
| Address | 51E/4 BARABAGAN LANE,MALLICK PARA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||