Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05296 | Date 30/05/2019 |
| Token No | SM/19-20/3728 30/05/2019 | Serial | 021 Last Visit: 30/05/2019 |
| Patient Name | Mrs. MAMONI GAYEN | Contact No | 9088698662 |
| Address | 128/81 TELIPARA BAGER BAGAN, BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||