Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05002 | Date 02/05/2019 |
| Token No | SM/19-20/2095 02/05/2019 | Serial | 066 Last Visit: 02/05/2019 |
| Patient Name | Mrs. GANGABALA MONDAL | Contact No | 7044017900 |
| Address | PAR DANKUNI , DANKUNI COAL COMPLEX | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||