Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04454 | Date 29/03/2019 |
| Token No | SM/19-20/6536 15/07/2019 | Serial | 079 Last Visit: 29/11/2019 |
| Patient Name | Mrs. TUMPA MANNA | Contact No | 8335863679 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||