Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07398 | Date 22/01/2020 |
| Token No | SM/19-20/17442 01/02/2020 | Serial | 053 Last Visit: 01/02/2020 |
| Patient Name | Mrs. PURNIMA SANYAL | Contact No | 7602052490 |
| Address | 205/A/A BAGER BAGAN TELIPARA, BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||