Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04857 | Date 23/04/2019 |
| Token No | SM/19-20/1478 23/04/2019 | Serial | 059 Last Visit: 21/09/2019 |
| Patient Name | Mrs. MADHABI DAS | Contact No | 7044627870 |
| Address | 184/2 SATCHASI PARA , BAIDYABATI (M) | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||