Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04759 | Date 18/04/2019 |
| Token No | SM/19-20/1127 18/04/2019 | Serial | 040 Last Visit: 18/04/2019 |
| Patient Name | Mrs. POUSHALI INDRA | Contact No | 9674474286 |
| Address | 22 SHEWRAPHULI , BAIDYABATI(M) | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||