Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06259 | Date 28/08/2019 |
| Token No | SM/19-20/9357 28/08/2019 | Serial | 080 Last Visit: 28/08/2019 |
| Patient Name | Mrs. CHAPALA BISWAS | Contact No | 9830856171 |
| Address | 49 SHITALA TALA ROAD,CHATRA,BAIDYABATI(M) | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||