Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03489 | Date 12/02/2019 |
| Token No | SM/19-20/2375 08/05/2019 | Serial | 066 Last Visit: 02/09/2019 |
| Patient Name | Mrs. GITA CHAKRABORTY | Contact No | 6291214290 |
| Address | 270/C CHARA BAGAN BAURI , BAIDYABATI (M) | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||