Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05459 | Date 17/06/2019 |
| Token No | SM/19-20/25422 03/09/2020 | Serial | 068 Last Visit: 07/01/2021 |
| Patient Name | Mrs. RAJMOTI DAS | Contact No | 7449881678 |
| Address | 8 KANAI DEWAN TALA BYE LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||