Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05227 | Date 25/05/2019 |
| Token No | SM/19-20/3413 25/05/2019 | Serial | 039 Last Visit: 25/05/2019 |
| Patient Name | Mrs. ANNAPURNA SHAW | Contact No | 9681248449 |
| Address | 14/A GHOSAL PARA NABAGRAM , BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||