Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07916 | Date 24/03/2020 |
| Token No | SM/19-20/20229 24/03/2020 | Serial | 050 Last Visit: 24/03/2020 |
| Patient Name | Mrs. DURGA PARUI | Contact No | 6289618214 |
| Address | 25/2 D.N. MUKHERJEE ROAD MALLICKPARA BAIDYABATI (M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||