Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05846 | Date 19/07/2019 |
| Token No | SM/19-20/6860 19/07/2019 | Serial | 050 Last Visit: 19/07/2019 |
| Patient Name | Mrs. CHAINA SARKER | Contact No | 8902326768 |
| Address | 218 RAJYADHARUR,GOVT COLONY,MALLICK PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||