Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05401 | Date 12/06/2019 |
| Token No | SM/19-20/5206 24/06/2019 | Serial | 072 Last Visit: 24/06/2019 |
| Patient Name | Mrs. MENOKA GHSOH | Contact No | 7278769134 |
| Address | 35 CHATRA MANA PARA RK ROAD , BAIDYABATI (M) | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||