Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04870 | Date 23/04/2019 |
| Token No | SM/19-20/1506 23/04/2019 | Serial | 087 Last Visit: 23/04/2019 |
| Patient Name | Mrs. KRISHANA SOM | Contact No | 8981587054 |
| Address | MARADAN, BAIDYABATI(M) | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||