Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05347 | Date 06/06/2019 |
| Token No | SM/19-20/4091 06/06/2019 | Serial | 067 Last Visit: 06/06/2019 |
| Patient Name | Mrs. PUJA SHAW | Contact No | 7044599225 |
| Address | 4,RAIFAI RANJ ROAD PARK SARKAS | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||