Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06568 | Date 27/09/2019 |
| Token No | SM/19-20/15913 26/12/2019 | Serial | 044 Last Visit: 06/01/2020 |
| Patient Name | Mrs. MALATI MAITI | Contact No | 9163456343 |
| Address | 486/320 G. T. ROAD,BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||