Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01066 | Date 12/09/2018 |
| Token No | SM/19-20/7921 05/08/2019 | Serial | 060 Last Visit: 10/08/2019 |
| Patient Name | Mrs. MAYA RANI DEY | Contact No | 8017175660 |
| Address | 153 CHATRA BAGHER BAGAN, BAIDYABATI(M) | Age | 63.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||