Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05806 | Date 17/07/2019 |
| Token No | SM/19-20/6661 17/07/2019 | Serial | 033 Last Visit: 17/07/2019 |
| Patient Name | Mrs. KALPANA AOUN | Contact No | |
| Address | 10/1 GODAR GAGAN,BAIDYABATI(M) | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||