Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05570 | Date 25/06/2019 |
| Token No | SM/19-20/8026 06/08/2019 | Serial | 047 Last Visit: 05/11/2019 |
| Patient Name | Mrs. SHASTI GHOSH | Contact No | 9123991640 |
| Address | 190/77/2 TELIPARA BAGER BAGAN , BAIDYABATI(M) | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||