Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08061 | Date 11/04/2020 |
| Token No | SM/19-20/21000 11/04/2020 | Serial | 023 Last Visit: 30/03/2021 |
| Patient Name | Mrs. MALATI PAL | Contact No | 9830431999 |
| Address | 32 KUMOR PARA LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||