Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06716 | Date 21/10/2019 |
| Token No | SM/19-20/19960 19/03/2020 | Serial | 063 Last Visit: 19/03/2020 |
| Patient Name | Mrs. PURNIMA GHOSH MAJUMDAR | Contact No | 8481042332 |
| Address | 19E G.D BHATTACHARJEE LANE CHATRA , BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||