Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05965 | Date 26/07/2019 |
| Token No | SM/19-20/12353 24/10/2019 | Serial | 028 Last Visit: 24/10/2019 |
| Patient Name | Miss ARPITA SARKAR | Contact No | 7872560643 |
| Address | 301/T/A TELIPARA BAGER BAGAN , BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||