Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07529 | Date 13/02/2020 |
| Token No | SM/19-20/18009 13/02/2020 | Serial | 028 Last Visit: 15/05/2020 |
| Patient Name | Miss RIYALI SOM | Contact No | 9681492923 |
| Address | 46/114 SATCHASI PARA LANE , BAIDYABATI(M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||