Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03259 | Date 31/01/2019 |
| Token No | SM/18-19/8763 15/02/2019 | Serial | 051 Last Visit: 20/03/2019 |
| Patient Name | Mrs. SANCHITA DAS | Contact No | 9674721875 |
| Address | BORAI,SHINGUR THANA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||