Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01128 | Date 14/09/2018 |
| Token No | SM/19-20/4229 10/06/2019 | Serial | 011 Last Visit: 13/06/2019 |
| Patient Name | Mrs. PURNIMA HALDER | Contact No | 9748244399 |
| Address | 189/82 TELIPARA BAGER BAGAN,BAIDYABATI(M) | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||