Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07333 | Date 13/01/2020 |
| Token No | SM/19-20/19348 11/03/2020 | Serial | 011 Last Visit: 22/09/2020 |
| Patient Name | Mrs. ANITA DAS | Contact No | 9062563661 |
| Address | GOILAPARA BAIDYABATI CHAK | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||