Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05878 | Date 22/07/2019 |
| Token No | SM/19-20/6983 22/07/2019 | Serial | 001 Last Visit: 05/08/2019 |
| Patient Name | Mrs. GOURI BHATTACHARYA | Contact No | 9674509759 |
| Address | TELIPARA BAGER BAGNA CHATRA, BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | 72 / min | Height | cm BMI: inf |
| Diagnosis | |||