Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05012 | Date 04/05/2019 |
| Token No | SM/19-20/2149 04/05/2019 | Serial | 009 Last Visit: 01/08/2019 |
| Patient Name | Miss SANGITA DUTTA | Contact No | 6290469273 |
| Address | 46 K.C. MUKHERJEE STREET CHATRA BAIDYABATI(M) | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||