Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08677 | Date 26/08/2020 |
| Token No | SM/19-20/25462 04/09/2020 | Serial | 033 Last Visit: 04/09/2020 |
| Patient Name | Mrs. SAMIRUN BIBI | Contact No | 9477030569 |
| Address | BAJE DHANYAHANA, BALARAMBATI, 712409 | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||