Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07136 | Date 12/12/2019 |
| Token No | SM/19-20/19946 19/03/2020 | Serial | 049 Last Visit: 19/03/2020 |
| Patient Name | Mrs. UMADI MOHALI | Contact No | 8420603577 |
| Address | PANDIT SATGHARA MALLICKPARA | Age | 41 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||