Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05281 | Date 29/05/2019 |
| Token No | SM/19-20/15115 12/12/2019 | Serial | 035 Last Visit: 12/12/2019 |
| Patient Name | Miss NAMITA DAS | Contact No | 7595883309 |
| Address | 20 SURESH CHANDRA GANGULY LANE SAKIA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||