Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05384 | Date 11/06/2019 |
| Token No | SM/19-20/4365 11/06/2019 | Serial | 041 Last Visit: 20/02/2020 |
| Patient Name | Mrs. KALPANA SARKAR | Contact No | 8240503732 |
| Address | 175(205A) TELI PARA BAGER BAGAN, BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||