Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05587 | Date 27/06/2019 |
| Token No | SM/19-20/6181 10/07/2019 | Serial | 049 Last Visit: 10/07/2019 |
| Patient Name | Mrs. JAYANTI MALIK | Contact No | 8013217276 |
| Address | CHATRA BAGER BAGAN , BAIDYABTI(M) | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||