Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04100 | Date 08/03/2019 |
| Token No | SM/19-20/4615 14/06/2019 | Serial | 090 Last Visit: 19/07/2019 |
| Patient Name | Mrs. MINATI MAJUMDAR | Contact No | 9903530981 |
| Address | 2 ,RAJDHAR PUR | Age | 62 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||