Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06825 | Date 09/11/2019 |
| Token No | SM/19-20/16505 10/01/2020 | Serial | 030 Last Visit: 10/01/2020 |
| Patient Name | Mrs. NUPUR PAL | Contact No | |
| Address | SHEORAPHULI HARISH/LANE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||