Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04528 | Date 03/04/2019 |
| Token No | SM/19-20/175 03/04/2019 | Serial | 030 Last Visit: 03/04/2019 |
| Patient Name | Mrs. MAHUA DEY | Contact No | 9051882757 |
| Address | 2/A G T ROAD CHATRA GODAR BAGAN , BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||