Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00901 | Date 04/09/2018 |
| Token No | SM/19-20/3574 28/05/2019 | Serial | 015 Last Visit: 28/05/2019 |
| Patient Name | Mrs. PADYARANI GHOSH | Contact No | |
| Address | JAGADHATRI PARA,CHATRA | Age | 75.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||