Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06072 | Date 06/08/2019 |
| Token No | SM/19-20/22750 04/06/2020 | Serial | 035 Last Visit: 04/06/2020 |
| Patient Name | Mrs. MOUSUMI RAY | Contact No | 9681758580 |
| Address | 61/A THAKURDAS BABU LANE | Age | 44 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||