Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05332 | Date 03/06/2019 |
| Token No | SM/19-20/4956 20/06/2019 | Serial | 096 Last Visit: 20/06/2019 |
| Patient Name | Mrs. SOBHA PATRA | Contact No | 8981173073 |
| Address | CHOTO BELUR MAESO PARA | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||