Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05990 | Date 29/07/2019 |
| Token No | SM/19-20/7509 29/07/2019 | Serial | 045 Last Visit: 29/07/2019 |
| Patient Name | Mrs. SHEPHALI MONDAL | Contact No | 9748637801 |
| Address | 18 P. L MUKHERJEE LANE BAHDRESWAR, CHAMPDANI(M) | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||