Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05488 | Date 20/06/2019 |
| Token No | SM/19-20/4885 20/06/2019 | Serial | 025 Last Visit: 20/06/2019 |
| Patient Name | Mrs. KARUNA DAS | Contact No | 8334989005 |
| Address | 19 NABIN CHAKRABORTY LANE,CHATRA,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||