Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04552 | Date 04/04/2019 |
| Token No | SM/19-20/269 04/04/2019 | Serial | 058 Last Visit: 14/09/2019 |
| Patient Name | Mrs. RANJITA ROUTH | Contact No | 8697302661 |
| Address | 11 RABINDRA BHABAN | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||