Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04779 | Date 20/04/2019 |
| Token No | SM/19-20/1233 20/04/2019 | Serial | 054 Last Visit: 20/04/2019 |
| Patient Name | Mrs. RINA RAUTH | Contact No | 9062573106 |
| Address | TETULTALA,BAGER BAGAN,BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||