Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07249 | Date 30/12/2019 |
| Token No | SM/19-20/16023 30/12/2019 | Serial | 012 Last Visit: 17/01/2020 |
| Patient Name | Mrs. SHIULI PATRA | Contact No | 9933846212 |
| Address | PARBATPUR ITLA BARDDHAMAN | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||