Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01606 | Date 10/10/2018 |
| Token No | SM/19-20/16824 17/01/2020 | Serial | 045 Last Visit: 17/01/2020 |
| Patient Name | Mrs. SAMINA WARSI | Contact No | 8100601484 |
| Address | KAJIPARA BAIDYABATI(M) | Age | 33 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||