Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02474 | Date 12/12/2018 |
| Token No | SM/19-20/4090 06/06/2019 | Serial | 066 Last Visit: 10/06/2019 |
| Patient Name | Mrs. INDU GUPTA | Contact No | 9830823144 |
| Address | CHATRA KUMOR PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 71 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||