Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06061 | Date 06/08/2019 |
| Token No | SM/19-20/7999 06/08/2019 | Serial | 020 Last Visit: 16/08/2019 |
| Patient Name | Mrs. MANJURI NATH | Contact No | 8981171610 |
| Address | 421/6 G. T. ROAD,BAIDYABATI(M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||