Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04999 | Date 02/05/2019 |
| Token No | SM/19-20/2083 02/05/2019 | Serial | 054 Last Visit: 02/05/2019 |
| Patient Name | Mrs. KABITA KAYAL | Contact No | 9748066487 |
| Address | 29/A PATI PARA , BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||