Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06703 | Date 21/10/2019 |
| Token No | SM/19-20/12844 07/11/2019 | Serial | 015 Last Visit: 07/11/2019 |
| Patient Name | Mrs. KAMALA PYNE | Contact No | 7890683653 |
| Address | 108, N.T ROAD , BAIDYABATI (M) | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||