Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08059 | Date 11/04/2020 |
| Token No | SM/19-20/21486 23/04/2020 | Serial | 033 Last Visit: 07/05/2020 |
| Patient Name | Mrs. MOU DAS | Contact No | 8017754286 |
| Address | B/AE/22 ARJUNPUR EAST,RAJARHAT,GOPALPUR(M) NORTH 24 PARGANA | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||