Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02987 | Date 14/01/2019 |
| Token No | SM/19-20/16514 10/01/2020 | Serial | 039 Last Visit: 24/02/2020 |
| Patient Name | Mrs. PURNIMA PRAMANIK | Contact No | 9807278225 |
| Address | CHATRA SHITLATALA, BAIDYABATI (M) | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||