Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04820 | Date 22/04/2019 |
| Token No | SM/19-20/2533 11/05/2019 | Serial | 021 Last Visit: 11/05/2019 |
| Patient Name | Mrs. SARBANI DEY | Contact No | 8479944683 |
| Address | CHOTO BELUR MAHESHO PARA | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||