Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03837 | Date 23/02/2019 |
| Token No | SM/18-19/9367 23/02/2019 | Serial | 053 Last Visit: 23/02/2019 |
| Patient Name | Mrs. NILIMA SRKAR | Contact No | 9874218754 |
| Address | SUBHASH NAGAR RISHRA(M) | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||