Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08015 | Date 06/04/2020 |
| Token No | SM/19-20/20756 06/04/2020 | Serial | 007 Last Visit: 06/04/2020 |
| Patient Name | Mrs. KAKALI PAYEN | Contact No | 7595860212 |
| Address | 55 NO CHATRA BARUI PARA LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||