Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06708 | Date 21/10/2019 |
| Token No | SM/19-20/12141 21/10/2019 | Serial | 038 Last Visit: 21/10/2019 |
| Patient Name | Mrs. ASIMA MONDAL | Contact No | 8013658632 |
| Address | 69 TELIPARA CHATRA , BAIDYBATI(M) | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||