Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07501 | Date 07/02/2020 |
| Token No | SM/19-20/17769 07/02/2020 | Serial | 042 Last Visit: 07/02/2020 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 9007772371 |
| Address | 212 TELIPARA BAGHER BAGAN,BAIDYABATI(M) | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||