Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02951 | Date 10/01/2019 |
| Token No | SM/18-19/7811 01/02/2019 | Serial | 087 Last Visit: 01/02/2019 |
| Patient Name | Mrs. ARATI GOSWAMI | Contact No | 9883677075 |
| Address | 31 THAKUR DAS BABU LANE | Age | 55 YES Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||