Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06435 | Date 16/09/2019 |
| Token No | SM/19-20/10500 16/09/2019 | Serial | 101 Last Visit: 16/09/2019 |
| Patient Name | Mrs. MENOKA BAG | Contact No | |
| Address | DAKHIN RAJDHYAPUR PASCHIMPARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||