Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07030 | Date 30/11/2019 |
| Token No | SM/19-20/14387 30/11/2019 | Serial | 061 Last Visit: 30/11/2019 |
| Patient Name | Mrs. RUPALI PAL | Contact No | 9903910106 |
| Address | 32 NO KUMAR PARA CHATRA SERAMPORE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||