Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 04493 | Date 01/04/2019 |
| Token No | SM/19-20/729 11/04/2019 | Serial | 036 Last Visit: 11/04/2019 |
| Patient Name | Mrs. PUSPA SARKAR | Contact No | 9163098892 |
| Address | CHATRA SHITLATALA , BIADYABATI(M) | Age | 64 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||