Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05557 | Date 25/06/2019 |
| Token No | SM/19-20/5713 02/07/2019 | Serial | 003 Last Visit: 02/07/2019 |
| Patient Name | Mrs. DURGA RANI SINGH | Contact No | 9088160129 |
| Address | 145/F TELI PARA LANE BAGER BAGAN BAIDYABATI(M) | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||