Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04670 | Date 11/04/2019 |
| Token No | SM/19-20/733 11/04/2019 | Serial | 040 Last Visit: 11/04/2019 |
| Patient Name | Mrs. MINATI NATH | Contact No | |
| Address | 266/55 CHATRA TELI PARA , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||