Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05119 | Date 15/05/2019 |
| Token No | SM/19-20/18283 18/02/2020 | Serial | 018 Last Visit: 18/02/2020 |
| Patient Name | Mrs. TUMPA MALAKAR | Contact No | 9836267739 |
| Address | 16/18 GD BHATTACHARJEE LANE CHATRA , BIADYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||