Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04503 | Date 02/04/2019 |
| Token No | SM/19-20/196 03/04/2019 | Serial | 051 Last Visit: 11/04/2019 |
| Patient Name | Mrs. LAXMI MALIK | Contact No | 8013715708 |
| Address | 41 KHAR PARA, NATUN PALLY, BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||