Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08065 | Date 13/04/2020 |
| Token No | SM/19-20/22072 09/05/2020 | Serial | 017 Last Visit: 09/05/2020 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 9831136408 |
| Address | 4 DR. G. C. GOSWAMI STREET | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||