Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07367 | Date 18/01/2020 |
| Token No | SM/19-20/19804 17/03/2020 | Serial | 063 Last Visit: 17/03/2020 |
| Patient Name | Mrs. DIPIKA RAY | Contact No | 9239092580 |
| Address | 100/84 MATI PARA , BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||