Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07539 | Date 14/02/2020 |
| Token No | SM/19-20/18089 14/02/2020 | Serial | 046 Last Visit: 14/02/2020 |
| Patient Name | Mrs. PUJA SHAW | Contact No | 9088610310 |
| Address | 6 NO DHULI PARA LANE | Age | 23 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||