Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04766 | Date 20/04/2019 |
| Token No | SM/19-20/1193 20/04/2019 | Serial | 014 Last Visit: 20/04/2019 |
| Patient Name | Mrs. PARBATI PAL | Contact No | 9836831386 |
| Address | CHATRA MANIK GHOSER BAGAN , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||