Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04563 | Date 05/04/2019 |
| Token No | SM/19-20/316 05/04/2019 | Serial | 022 Last Visit: 06/04/2019 |
| Patient Name | Mrs. RAMA DUTTA | Contact No | 7890035347 |
| Address | 474 BARUI PARA CHARABAGAN , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||