Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06850 | Date 13/11/2019 |
| Token No | SM/19-20/13155 13/11/2019 | Serial | 082 Last Visit: 16/11/2019 |
| Patient Name | Mrs. PALLABI HALDAR | Contact No | 8017562911 |
| Address | 233 SHEWARAPHULI BAWRI PARA CHARA BAGAN , BAIDYBATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||