Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03787 | Date 22/02/2019 |
| Token No | SM/18-19/9258 22/02/2019 | Serial | 035 Last Visit: 22/02/2019 |
| Patient Name | Mrs. RITA GHOSH | Contact No | 7278338367 |
| Address | RISHRA PANCH LAKHI | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||