Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07638 | Date 26/02/2020 |
| Token No | SM/19-20/18710 26/02/2020 | Serial | 053 Last Visit: 26/02/2020 |
| Patient Name | Mrs. SABITA SEAL | Contact No | 7686950542 |
| Address | 62/1 G. T. ROAD ,NABAGRAM BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||