Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 08631 | Date 06/08/2020 |
| Token No | SM/19-20/24764 06/08/2020 | Serial | 039 Last Visit: 06/08/2020 |
| Patient Name | Mrs. GITA NAYAK | Contact No | 7278899484 |
| Address | 16 RAJA K. L. GOSWAMI STREET | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||