Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04675 | Date 12/04/2019 |
| Token No | SM/19-20/2699 14/05/2019 | Serial | 013 Last Visit: 14/05/2019 |
| Patient Name | Mrs. SIDESWARI MONDAL | Contact No | 9804029062 |
| Address | 32/2 K.C MUKHERJEE STREET CHATRA SHITLATALA , BAIDYABATI(M) | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||