Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03788 | Date 22/02/2019 |
| Token No | SM/18-19/9261 22/02/2019 | Serial | 038 Last Visit: 22/02/2019 |
| Patient Name | Mrs. RINA DAS | Contact No | 7044979628 |
| Address | RISHRA MORPUKUR DAKHIN PARA | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||