Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05262 | Date 28/05/2019 |
| Token No | SM/19-20/3570 28/05/2019 | Serial | 011 Last Visit: 20/06/2019 |
| Patient Name | Mrs. TIYA TANTI | Contact No | 9874359966 |
| Address | BORA JHANKARI BORA HOOGHLY | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||