Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05422 | Date 13/06/2019 |
| Token No | SM/19-20/4514 13/06/2019 | Serial | 069 Last Visit: 13/06/2019 |
| Patient Name | Mrs. RADHA RANI HALDER | Contact No | 9123646074 |
| Address | 189/82 TELIPARA BAGER BAGAN CHATRA , BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||