Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08056 | Date 09/04/2020 |
| Token No | SM/19-20/20975 09/04/2020 | Serial | 053 Last Visit: 18/04/2020 |
| Patient Name | Mrs. CHUMKI PAL | Contact No | 9073626013 |
| Address | 72 MUKHERJEE PARA LANE, | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||