Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05963 | Date 26/07/2019 |
| Token No | SM/19-20/7344 26/07/2019 | Serial | 013 Last Visit: 18/03/2020 |
| Patient Name | Mrs. SHYAMALI RAY | Contact No | 9804228979 |
| Address | 301 TELI PARA BAGER , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||