Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02836 | Date 05/01/2019 |
| Token No | SM/19-20/11358 30/09/2019 | Serial | 031 Last Visit: 21/01/2020 |
| Patient Name | Mrs. MALA BELAL | Contact No | 9883823256 |
| Address | BAGER BAGN TELI PARA , BAIDYABATI(M) | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||