Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06787 | Date 05/11/2019 |
| Token No | SM/19-20/12646 05/11/2019 | Serial | 020 Last Visit: 05/11/2019 |
| Patient Name | Mrs. SHYAMALI MALIK | Contact No | 7278607877 |
| Address | 66/1H//1H RAMKRISHANA ROAD CHATRA , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||