Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06183 | Date 21/08/2019 |
| Token No | SM/19-20/8846 21/08/2019 | Serial | 008 Last Visit: 09/09/2019 |
| Patient Name | Mrs. TUMPA BHOWMIK | Contact No | 8017671290 |
| Address | 186 VIVEKANANDA SARANI NABAGRAM , BAIDYABATI(M) | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||