Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03378 | Date 05/02/2019 |
| Token No | SM/18-19/8038 05/02/2019 | Serial | 029 Last Visit: 05/02/2019 |
| Patient Name | Mrs. KALYANI HAJRA | Contact No | 8013879495 |
| Address | CHATRA,GHOSH PARA ,FAST LANE. | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||