Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08430 | Date 26/06/2020 |
| Token No | SM/19-20/23446 26/06/2020 | Serial | 021 Last Visit: 29/06/2020 |
| Patient Name | Mrs. MALATI DAS | Contact No | |
| Address | K. M. SHA STREET | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||