Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06407 | Date 14/09/2019 |
| Token No | SM/19-20/10368 14/09/2019 | Serial | 047 Last Visit: 14/09/2019 |
| Patient Name | Mrs. DIPALI SINGHA | Contact No | |
| Address | CHAKLA PARA PROBHASNAGAR | Age | 60 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||