Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05007 | Date 03/05/2019 |
| Token No | SM/19-20/2118 03/05/2019 | Serial | 022 Last Visit: 03/05/2019 |
| Patient Name | Mrs. KABITA DAS | Contact No | 6291323896 |
| Address | CHATU GUNGE PARA ROAD, | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||