Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06711 | Date 21/10/2019 |
| Token No | SM/19-20/12151 21/10/2019 | Serial | 048 Last Visit: 21/10/2019 |
| Patient Name | Mrs. SAGARIKA MONDAL | Contact No | 9088141233 |
| Address | 57 JD GT ROAD PAMPA NAGAR , BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 77 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||