Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08720 | Date 08/09/2020 |
| Token No | SM/19-20/25535 08/09/2020 | Serial | 049 Last Visit: 08/09/2020 |
| Patient Name | Mrs. RINA MAJHI | Contact No | 9007690927 |
| Address | 5 B D.N MUKHERJEE ROAD MALLICKPARA BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||