Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03816 | Date 23/02/2019 |
| Token No | SM/18-19/9316 23/02/2019 | Serial | 002 Last Visit: 23/02/2019 |
| Patient Name | Mrs. MANJIRA BIBI | Contact No | |
| Address | KAJIPARA,BAIDYABATI(M) | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||