Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07067 | Date 04/12/2019 |
| Token No | SM/19-20/14633 04/12/2019 | Serial | 019 Last Visit: 18/12/2019 |
| Patient Name | Mrs. SUMITA GHOSH | Contact No | 9831032994 |
| Address | 298(109), G.T ROAD CHATRA MANSATALA, BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||