Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 08136 | Date 23/04/2020 |
| Token No | SM/19-20/21674 28/04/2020 | Serial | 023 Last Visit: 29/06/2020 |
| Patient Name | Mrs. RITA AGRAHRI | Contact No | 9674111752 |
| Address | 36/A K.M. BHATTACHARYA STREET | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||