Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05118 | Date 15/05/2019 |
| Token No | SM/19-20/2803 15/05/2019 | Serial | 043 Last Visit: 10/02/2020 |
| Patient Name | Mrs. REBA MALAKAR | Contact No | 9836267739 |
| Address | 17/2 CHATRA SHITLATALA , BAIDYABATI (M) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||