Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06517 | Date 23/09/2019 |
| Token No | SM/19-20/10967 23/09/2019 | Serial | 094 Last Visit: 23/09/2019 |
| Patient Name | Miss TINA BANGAL | Contact No | 9804012934 |
| Address | 48/B MUKHERJEE PARA LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||