Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04204 | Date 15/03/2019 |
| Token No | SM/18-19/10518 15/03/2019 | Serial | 011 Last Visit: 02/04/2019 |
| Patient Name | Mrs. SABITRI MALLIK | Contact No | 9874278162 |
| Address | SHANKARBATI CHANDANNAGAR | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||