Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03401 | Date 06/02/2019 |
| Token No | SM/18-19/8124 06/02/2019 | Serial | 018 Last Visit: 06/02/2019 |
| Patient Name | Mrs. AMIT PAL | Contact No | 9830460282 |
| Address | 57 CHATRA,DHARMA TALA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||