Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06324 | Date 03/09/2019 |
| Token No | SM/19-20/9741 03/09/2019 | Serial | 052 Last Visit: 03/09/2019 |
| Patient Name | Mrs. LAXMI MANNA | Contact No | 9038717822 |
| Address | 171 G.T ROAD W TANK , BAIDYABATI(M) | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||