Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03575 | Date 14/02/2019 |
| Token No | SM/19-20/1626 25/04/2019 | Serial | 012 Last Visit: 25/04/2019 |
| Patient Name | Mrs. BABLU DAS | Contact No | 7595844842 |
| Address | CHATRA TETULTALA TELI PARA , BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||