Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07548 | Date 15/02/2020 |
| Token No | SM/19-20/18114 15/02/2020 | Serial | 013 Last Visit: 15/02/2020 |
| Patient Name | Mrs. KALPANA DAS | Contact No | |
| Address | 159 G.T ROAD BAIDYABATI , CHATRA SERAMPORE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||