Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08587 | Date 24/07/2020 |
| Token No | SM/19-20/24441 24/07/2020 | Serial | 058 Last Visit: 24/07/2020 |
| Patient Name | Mrs. SULTA PURUKAIT | Contact No | 8777852373 |
| Address | 111B J N LAHIRI ROAD , LAXMI NARAYAN BHAWAN (4TH FLOOR ROOM NO.404) | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||