Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05114 | Date 15/05/2019 |
| Token No | SM/19-20/6079 08/07/2019 | Serial | 052 Last Visit: 07/02/2020 |
| Patient Name | Mrs. JAMUNA DUTTA | Contact No | 9239149859 |
| Address | 46 KC MUKHERJEE STREET (BELEL PARA) CHATRA , BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||