Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02187 | Date 28/11/2018 |
| Token No | SM/19-20/4354 11/06/2019 | Serial | 030 Last Visit: 02/07/2019 |
| Patient Name | Mrs. REKHA HALDAR | Contact No | |
| Address | CHATRA BAGER BAGAN , BAIDYABATI (M) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||