Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 06578 | Date 30/09/2019 |
| Token No | SM/19-20/11305 30/09/2019 | Serial | 030 Last Visit: 30/09/2019 |
| Patient Name | Mrs. SAMITA DEY | Contact No | 9088657182 |
| Address | 65/15 PRAVASH NAGAR | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||