Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05664 | Date 05/07/2019 |
| Token No | SM/19-20/5866 05/07/2019 | Serial | 029 Last Visit: 05/07/2019 |
| Patient Name | Mrs. ANKITA PARUI | Contact No | 7450863195 |
| Address | 24/4 DN MUKHERJEE ROAD , BAIDYABATI(M) | Age | 21 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 73 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||