Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03435 | Date 07/02/2019 |
| Token No | SM/19-20/677 10/04/2019 | Serial | 043 Last Visit: 29/05/2019 |
| Patient Name | Mrs. PINKI BASHU | Contact No | 7595858286 |
| Address | CHATRA,BAGHER BAGAN,TELI PARA,BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||