Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05417 | Date 13/06/2019 |
| Token No | SM/19-20/4504 13/06/2019 | Serial | 059 Last Visit: 13/06/2019 |
| Patient Name | Mrs. KALPANA DUTTA | Contact No | 8697907897 |
| Address | 601 PIYARAPUR, J.K SARKAR ROAD , SHEROPHULI , BAIDYABATI(M) | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||