Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05992 | Date 29/07/2019 |
| Token No | SM/19-20/21576 27/04/2020 | Serial | 003 Last Visit: 27/04/2020 |
| Patient Name | Miss LILI DEY | Contact No | 7003793363 |
| Address | 218 G.T ROAD CHATRA TELIPARA BAGER BAGAN, BAIDYABATI (M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||