Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06873 | Date 15/11/2019 |
| Token No | SM/19-20/13310 15/11/2019 | Serial | 043 Last Visit: 15/11/2019 |
| Patient Name | Mrs. JAYANTI ASH | Contact No | 8017626557 |
| Address | 17 GODAR BAGAN , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||