Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06763 | Date 26/10/2019 |
| Token No | SM/19-20/12460 26/10/2019 | Serial | 029 Last Visit: 26/10/2019 |
| Patient Name | Mrs. RANI DEVI MAHATO | Contact No | 8420572739 |
| Address | 14 J.M LAHIRI ANE SERAMPORE | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||