Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03036 | Date 17/01/2019 |
| Token No | SM/19-20/4539 14/06/2019 | Serial | 014 Last Visit: 14/06/2019 |
| Patient Name | Mrs. SOMA NASKAR | Contact No | 7686890927 |
| Address | CHATRA GODAR BAGAN BY LANE , BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||