Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05815 | Date 17/07/2019 |
| Token No | SM/19-20/6714 17/07/2019 | Serial | 086 Last Visit: 17/07/2019 |
| Patient Name | Mrs. GITA GUCHHAIT | Contact No | 8292326068 |
| Address | 201 TELI PARA BAGER BAGAN,BAIDYABATI(M) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||