Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05738 | Date 11/07/2019 |
| Token No | SM/19-20/6299 11/07/2019 | Serial | 049 Last Visit: 11/07/2019 |
| Patient Name | Mrs. GIRJA DEBI SHAW | Contact No | 9875373363 |
| Address | 542/MRAMMOHAN SARANI ,BAIDYABATI(M) | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||