Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02904 | Date 08/01/2019 |
| Token No | SM/18-19/6497 08/01/2019 | Serial | 051 Last Visit: 08/01/2019 |
| Patient Name | Mrs. SHAMPA SARKAR | Contact No | 9609302083 |
| Address | BARDHARMAN,UCHALAN | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||