Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05823 | Date 18/07/2019 |
| Token No | SM/19-20/6760 18/07/2019 | Serial | 035 Last Visit: 18/07/2019 |
| Patient Name | Mrs. SEPHALI RANI PAL | Contact No | 9674139571 |
| Address | 209/G TELIPARA,BAIDYABATI(M) | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||