Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06247 | Date 28/08/2019 |
| Token No | SM/19-20/9295 28/08/2019 | Serial | 018 Last Visit: 28/08/2019 |
| Patient Name | Mrs. NANDITA DAS | Contact No | 9874612605 |
| Address | BARUIPARA CHARABAGAN SHEORAPHULI , BAIDYABATI(M) | Age | 32 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||