Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04186 | Date 12/03/2019 |
| Token No | SM/19-20/401 06/04/2019 | Serial | 029 Last Visit: 06/04/2019 |
| Patient Name | Mrs. MAINA PAL | Contact No | 9433984311 |
| Address | 208 CHATRA TETULTALA BAJAR, BAIDYABATI (M) | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||