Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04935 | Date 27/04/2019 |
| Token No | SM/19-20/1763 27/04/2019 | Serial | 012 Last Visit: 09/12/2019 |
| Patient Name | Mrs. MINARANI DAS | Contact No | 8017349723 |
| Address | KACHUTIA, KACHUTIA, BARDHAMAN , KETUGRAM | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||