Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00180 | Date 06/08/2018 |
| Token No | SM/18-19/5319 15/12/2018 | Serial | 051 Last Visit: 15/12/2018 |
| Patient Name | Mrs. NAMRATA DAS | Contact No | 7980478789 |
| Address | BAIDYABATI | Age | 28.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||