Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05440 | Date 14/06/2019 |
| Token No | SM/19-20/4612 14/06/2019 | Serial | 087 Last Visit: 14/06/2019 |
| Patient Name | Mrs. PIYALI DEBNATH | Contact No | 9635973069 |
| Address | 2 KOLONI,RAJJODHARPUR | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||