Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07537 | Date 14/02/2020 |
| Token No | SM/19-20/18076 14/02/2020 | Serial | 033 Last Visit: 30/04/2020 |
| Patient Name | Mrs. PUTUL DAS | Contact No | 8617269014 |
| Address | 20/11 KALITALA LANE BAIDYABATI(M) | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||