Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06815 | Date 07/11/2019 |
| Token No | SM/19-20/12866 07/11/2019 | Serial | 037 Last Visit: 07/11/2019 |
| Patient Name | Mrs. RINA BEGAM | Contact No | 9836986024 |
| Address | 187AP GHOSH ROAD | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||