Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03411 | Date 06/02/2019 |
| Token No | SM/18-19/8152 06/02/2019 | Serial | 046 Last Visit: 06/02/2019 |
| Patient Name | Mrs. PRATIMA PAL | Contact No | 9836421352 |
| Address | 41/A CHATRA KUMAR PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||