Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08115 | Date 20/04/2020 |
| Token No | SM/19-20/21347 20/04/2020 | Serial | 022 Last Visit: 04/05/2020 |
| Patient Name | Mrs. SHEMALI MONDAL | Contact No | 7872208022 |
| Address | CHATRA TETUL TALA,BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||