Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06926 | Date 20/11/2019 |
| Token No | SM/19-20/13786 22/11/2019 | Serial | 035 Last Visit: 22/11/2019 |
| Patient Name | Mrs. GITA DAS | Contact No | 9674426033 |
| Address | 2 NO RAJYADHARPUR GOVT COLONY | Age | 72 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||