Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05824 | Date 18/07/2019 |
| Token No | SM/19-20/6778 18/07/2019 | Serial | 053 Last Visit: 18/07/2019 |
| Patient Name | Mrs. BASANTI SHAT | Contact No | 7890627368 |
| Address | CHATRA,GODER BAGAN,BAIDYABATI(M) | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||