Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03485 | Date 09/02/2019 |
| Token No | SM/19-20/6326 11/07/2019 | Serial | 076 Last Visit: 28/08/2019 |
| Patient Name | Mrs. UMA BAISALI | Contact No | 9836105040 |
| Address | 44/68 CHATRA SHITLATALA BAIDYABATI(M) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||