Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07199 | Date 20/12/2019 |
| Token No | SM/19-20/15669 20/12/2019 | Serial | 038 Last Visit: 20/12/2019 |
| Patient Name | Mrs. REKHA SARDAR | Contact No | 8481866868 |
| Address | 10/A/Z/F GODAR BAGAN BYE LANE CHATRA , BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||