Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04174 | Date 11/03/2019 |
| Token No | SM/19-20/124 02/04/2019 | Serial | 062 Last Visit: 02/04/2019 |
| Patient Name | Mrs. PARBOTI BISWAS | Contact No | 9681487885 |
| Address | CHATRA LANKAR BAGAN , BAIDYABATI (M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||