Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05421 | Date 13/06/2019 |
| Token No | SM/19-20/4513 13/06/2019 | Serial | 068 Last Visit: 13/06/2019 |
| Patient Name | Mrs. NAMITA GHOSH | Contact No | 9163679792 |
| Address | 119 CHATRA MUKHERJEE PARA , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||