Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03115 | Date 21/01/2019 |
| Token No | SM/19-20/514 08/04/2019 | Serial | 078 Last Visit: 08/04/2019 |
| Patient Name | Mrs. PAMPA BERA | Contact No | 9051168155 |
| Address | CHATRA NABIN CHAKRABORTY LANE , BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||