Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08429 | Date 25/06/2020 |
| Token No | SM/19-20/23422 25/06/2020 | Serial | 061 Last Visit: 25/06/2020 |
| Patient Name | Mrs. MAMATA SIL | Contact No | 8420595562 |
| Address | 32/A/H GT ROAD NABAGRAM , BAIDYABATI(M) | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||