Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07590 | Date 20/02/2020 |
| Token No | SM/19-20/18450 20/02/2020 | Serial | 042 Last Visit: 20/02/2020 |
| Patient Name | Mrs. SANTOSHI CHATTORAJ | Contact No | 9804522835 |
| Address | 67 GOALA PARA PANCHANAN TALA , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||