Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05922 | Date 24/07/2019 |
| Token No | SM/19-20/8418 16/08/2019 | Serial | 001 Last Visit: 30/09/2019 |
| Patient Name | Mrs. FUL KUMARI RAJAK | Contact No | 7980185360 |
| Address | 237 CHARABAGAN BAURIPARA , BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||