Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02642 | Date 21/12/2018 |
| Token No | SM/19-20/14898 09/12/2019 | Serial | 008 Last Visit: 09/12/2019 |
| Patient Name | Mrs. SAGARIKA SAMANTA | Contact No | 6289303978 |
| Address | 57 G /A G T ROAD,BAIDYABATY(M) | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||