Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06649 | Date 16/10/2019 |
| Token No | SM/19-20/11817 16/10/2019 | Serial | 035 Last Visit: 16/10/2019 |
| Patient Name | Mrs. RINA DEY | Contact No | 9748617558 |
| Address | 54/23 PATI PARA LANE , BAIDYABATI (M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||