Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03754 | Date 21/02/2019 |
| Token No | SM/18-19/9167 21/02/2019 | Serial | 029 Last Visit: 21/02/2019 |
| Patient Name | Mrs. SHYAMLI SAHA | Contact No | |
| Address | RISHRA SUBHASH NAGAR | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||