Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 07204 | Date 20/12/2019 |
| Token No | SM/19-20/15690 20/12/2019 | Serial | 059 Last Visit: 20/12/2019 |
| Patient Name | Mrs. MINA DEBI | Contact No | 9748876016 |
| Address | 19/4 NETAJI SUBHASH ROAD | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||