Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06231 | Date 27/08/2019 |
| Token No | SM/19-20/9197 27/08/2019 | Serial | 005 Last Visit: 27/08/2019 |
| Patient Name | Mrs. ARATI KOLEY | Contact No | 9330634127 |
| Address | G T ROAD MORADAN , BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||