Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04776 | Date 20/04/2019 |
| Token No | SM/19-20/1226 20/04/2019 | Serial | 047 Last Visit: 20/08/2019 |
| Patient Name | Mrs. SHIBANI GHATAK | Contact No | 8420587322 |
| Address | PAMPA NAGAR, BAIDYABATI(M) | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||