Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04322 | Date 20/03/2019 |
| Token No | SM/19-20/3237 22/05/2019 | Serial | 078 Last Visit: 22/05/2019 |
| Patient Name | Mrs. RINKU DAS | Contact No | 9883831748 |
| Address | 162D/F CHATRA TELI PARA BAGER BAGAN, BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||