Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04097 | Date 08/03/2019 |
| Token No | SM/18-19/10197 08/03/2019 | Serial | 088 Last Visit: 08/03/2019 |
| Patient Name | Mrs. SAMA SANTRA | Contact No | 9051746622 |
| Address | CHOTO BELUR CHECK POST | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||