Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 05581 | Date 26/06/2019 |
| Token No | SM/19-20/7314 25/07/2019 | Serial | 067 Last Visit: 27/08/2022 |
| Patient Name | Mrs. SHANKARI PAL | Contact No | 9230413804 |
| Address | 210SHITALATALA ROAD BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||