Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00992 | Date 08/09/2018 |
| Token No | SM/18-19/1379 08/09/2018 | Serial | 008 Last Visit: 08/09/2018 |
| Patient Name | Mrs. PRATIMA PAL | Contact No | 9830254084 |
| Address | 8/A/1 CHATRA KUMAR PARA | Age | 39.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||