Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04572 | Date 05/04/2019 |
| Token No | SM/19-20/336 05/04/2019 | Serial | 042 Last Visit: 05/04/2019 |
| Patient Name | Mrs. BINAPANI SADHUKHAN | Contact No | |
| Address | CHATRA POTI PARA,BAIDYABATI(M) | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||