Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 03873 | Date 26/02/2019 |
| Token No | SM/19-20/17395 01/02/2020 | Serial | 006 Last Visit: 01/02/2020 |
| Patient Name | Mrs. SUKLA GOSWAMI | Contact No | 9007556313 |
| Address | 31,THAKURDAS BABU LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||