Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06044 | Date 02/08/2019 |
| Token No | SM/19-20/7859 02/08/2019 | Serial | 091 Last Visit: 02/08/2019 |
| Patient Name | Mrs. ANIMA BASALI | Contact No | 8444816277 |
| Address | 112/2 SHITALA TALA ROAD CHATRA , BAIDYABATI(M) | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||