Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05404 | Date 13/06/2019 |
| Token No | SM/19-20/4970 20/06/2019 | Serial | 110 Last Visit: 20/06/2019 |
| Patient Name | Mrs. KAKULI KUNDU | Contact No | 8334072588 |
| Address | 62/C GT ROAD MARADAN NABAGRAM , BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||