Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05150 | Date 17/05/2019 |
| Token No | SM/19-20/2932 17/05/2019 | Serial | 036 Last Visit: 01/09/2021 |
| Patient Name | Mrs. LALITA DUTTA | Contact No | 8902554130 |
| Address | 124/1 G.T ROAD NABAGRAM BAIDHYABATI | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||