Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07736 | Date 11/03/2020 |
| Token No | SM/19-20/19479 12/03/2020 | Serial | 041 Last Visit: 04/05/2020 |
| Patient Name | Mrs. MITHU DEBNATH | Contact No | 9681117342 |
| Address | 10/A/Z/Y/H/1 G.T ROAD , DIPPUKUR PAMPA NAGAR , BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||