Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08166 | Date 28/04/2020 |
| Token No | SM/19-20/21672 28/04/2020 | Serial | 021 Last Visit: 28/04/2020 |
| Patient Name | Mrs. ARATI ROY | Contact No | |
| Address | 131 SITALATALA ROAD BAIDYABATI M | Age | 59 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||