Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04490 | Date 30/03/2019 |
| Token No | SM/18-19/11661 30/03/2019 | Serial | 076 Last Visit: 12/04/2019 |
| Patient Name | Mrs. SHUBHENDU PATRA | Contact No | 8420987175 |
| Address | BORA NIJAMPUR | Age | 28 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||