Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05172 | Date 21/05/2019 |
| Token No | SM/19-20/3058 21/05/2019 | Serial | 006 Last Visit: 21/05/2019 |
| Patient Name | Mrs. MAHUYA DEY | Contact No | 8582865297 |
| Address | 247/H CHARA BAGAN BARUI PARA , BAIDYABATI(M) | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||