Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03416 | Date 06/02/2019 |
| Token No | SM/18-19/10068 07/03/2019 | Serial | 071 Last Visit: 25/06/2019 |
| Patient Name | Mrs. MANJU DAS | Contact No | 8017057792 |
| Address | 11/36 BAISNAV PARA 1ST LANE MAHESH | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||