Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03682 | Date 18/02/2019 |
| Token No | SM/18-19/8957 18/02/2019 | Serial | 130 Last Visit: 18/02/2019 |
| Patient Name | Mrs. SUSHMITA SARKAR | Contact No | 9681465290 |
| Address | SIRAMPUR TALPUKAR RAJDHARPUR | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||