Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08475 | Date 03/07/2020 |
| Token No | SM/19-20/24711 04/08/2020 | Serial | 021 Last Visit: 17/08/2020 |
| Patient Name | Mrs. SABITA SASMAL | Contact No | |
| Address | 40/B BHATTACHARJEE GARDEN BYE LANE NABAGRAM BAIDYABATI M | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||