Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 06576 | Date 30/09/2019 |
| Token No | SM/19-20/11287 30/09/2019 | Serial | 012 Last Visit: 30/09/2019 |
| Patient Name | Mrs. RUPA SAHA | Contact No | 8013294545 |
| Address | 10 DR. BAGAN LANE,MALLICK PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||