Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05842 | Date 19/07/2019 |
| Token No | SM/19-20/6847 19/07/2019 | Serial | 037 Last Visit: 28/12/2019 |
| Patient Name | Mrs. PIYALI MONDAL | Contact No | 7890722795 |
| Address | 66/1/F/P(195) R. K. ROAD,BAIDYABATI(M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||