Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04720 | Date 16/04/2019 |
| Token No | SM/19-20/1739 26/04/2019 | Serial | 051 Last Visit: 26/04/2019 |
| Patient Name | Mrs. SUPRIYA DAS | Contact No | 9831515899 |
| Address | AMADPUR KANSARIPARA MEMARI BURDWAN | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||