Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 08150 | Date 25/04/2020 |
| Token No | SM/19-20/21568 25/04/2020 | Serial | 020 Last Visit: 26/08/2020 |
| Patient Name | Mrs. DIPALI DHARA | Contact No | 8648880677 |
| Address | 132 N.S AVENUE SHEORAPHULI | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||