Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06342 | Date 06/09/2019 |
| Token No | SM/19-20/18140 15/02/2020 | Serial | 039 Last Visit: 12/10/2020 |
| Patient Name | Mrs. MOUMITA DALUI | Contact No | 7679722368 |
| Address | 30/A KANAI DEWAN TALA LANE , BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||