Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04898 | Date 24/04/2019 |
| Token No | SM/19-20/1824 27/04/2019 | Serial | 073 Last Visit: 12/10/2019 |
| Patient Name | Mrs. ANITA SANTRA | Contact No | 7044249632 |
| Address | CHATRA TETUL TALA GODAR BAGAN , BAIDYABTI(M) RATION CARD-PHH 0120916565 | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||