Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06973 | Date 23/11/2019 |
| Token No | SM/19-20/14495 02/12/2019 | Serial | 088 Last Visit: 02/12/2019 |
| Patient Name | Mrs. MADHOBI GHOSH | Contact No | 9874916721 |
| Address | 21 CHATRA BOU BAZAR TELI PARA , BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||