Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04285 | Date 18/03/2019 |
| Token No | SM/19-20/2489 10/05/2019 | Serial | 086 Last Visit: 01/02/2020 |
| Patient Name | Mrs. DEBAKI MAITY | Contact No | 8585074130 |
| Address | CHATRA PAMPA NAGAR , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||