Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06252 | Date 28/08/2019 |
| Token No | SM/19-20/9321 28/08/2019 | Serial | 044 Last Visit: 28/08/2019 |
| Patient Name | Mrs. TAPASI BAIDYA | Contact No | |
| Address | 78 BAGER BAGAN TELIPARA , BAIDYABATI(M) | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||