Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03250 | Date 31/01/2019 |
| Token No | SM/19-20/19437 11/03/2020 | Serial | 100 Last Visit: 30/06/2020 |
| Patient Name | Mrs. RANU KHATUN | Contact No | |
| Address | 8 CHATRA, KUMOR PARA,ARABINDA SWARANI | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||