Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03203 | Date 29/01/2019 |
| Token No | SM/19-20/2603 13/05/2019 | Serial | 014 Last Visit: 13/05/2019 |
| Patient Name | Mrs. TAPASHI DAS | Contact No | 9674559563 |
| Address | 14, SIDESWARI LANE | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||