Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06494 | Date 21/09/2019 |
| Token No | SM/19-20/15597 19/12/2019 | Serial | 026 Last Visit: 19/12/2019 |
| Patient Name | Mrs. JHARNA GHOSH | Contact No | 7001727299 |
| Address | 27 KUMAR PARA LANE,CHATRA | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||