Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06623 | Date 14/10/2019 |
| Token No | SM/19-20/11663 14/10/2019 | Serial | 057 Last Visit: 14/10/2019 |
| Patient Name | Mrs. PURNIMA PAL | Contact No | 9748239377 |
| Address | 47(256) TALIPARA,BAIDYABATI(M) | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||