Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06977 | Date 25/11/2019 |
| Token No | SM/19-20/13904 25/11/2019 | Serial | 013 Last Visit: 25/11/2019 |
| Patient Name | Mrs. JHARNA ADAK | Contact No | 9674855790 |
| Address | KOLAYPARA O SI PARA , SINGUR | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||