Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05991 | Date 29/07/2019 |
| Token No | SM/19-20/7514 29/07/2019 | Serial | 050 Last Visit: 29/07/2019 |
| Patient Name | Mrs. PUTUL DEY | Contact No | 7003793363 |
| Address | 218 G.T ROAD CHATRA TELIPARA BAGER BAGAN , BAIDYABATI(M) | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/78 mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||