Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03927 | Date 01/03/2019 |
| Token No | SM/18-19/9648 01/03/2019 | Serial | 023 Last Visit: 01/03/2019 |
| Patient Name | Mrs. TAPASI ROY | Contact No | 8583090971 |
| Address | 43/B PRAVASNAGER | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||