Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08502 | Date 07/07/2020 |
| Token No | SM/19-20/23880 07/07/2020 | Serial | 045 Last Visit: 07/07/2020 |
| Patient Name | Mrs. SHAMOLY BAGCHI | Contact No | 8697949215 |
| Address | FLAT NO. 203,BORO BAGAN LANE | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||