Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08105 | Date 18/04/2020 |
| Token No | SM/19-20/21301 18/04/2020 | Serial | 010 Last Visit: 18/04/2020 |
| Patient Name | Mrs. MANJUBALA NASKAR | Contact No | 9681771282 |
| Address | CHOTOBELU ,MAHISHYA PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||