Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05492 | Date 20/06/2019 |
| Token No | SM/19-20/4919 20/06/2019 | Serial | 059 Last Visit: 20/06/2019 |
| Patient Name | Mrs. RADHA RANI PAIN | Contact No | |
| Address | 15 BANIYA PARA LANE SERAMPORE | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||