Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07979 | Date 31/03/2020 |
| Token No | SM/19-20/20555 31/03/2020 | Serial | 025 Last Visit: 31/03/2020 |
| Patient Name | Mrs. PUJA GOSWAMI | Contact No | 8336902567 |
| Address | CHATRA BAGER BAGAN | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||