Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05755 | Date 13/07/2019 |
| Token No | SM/19-20/14845 07/12/2019 | Serial | 012 Last Visit: 14/12/2019 |
| Patient Name | Mrs. ASHA RANI RAM | Contact No | 9051464710 |
| Address | 23 CHHATUGUNJ,BAIDYABATI(M) | Age | 50 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||