Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01320 | Date 25/09/2018 |
| Token No | SM/18-19/2368 03/10/2018 | Serial | 023 Last Visit: 18/11/2019 |
| Patient Name | Mrs. SONALI PAL | Contact No | 9062236122 |
| Address | 8A/1,CHATRA KUMARPARA | Age | 38 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||