Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05648 | Date 02/07/2019 |
| Token No | SM/19-20/5774 02/07/2019 | Serial | 064 Last Visit: 02/07/2019 |
| Patient Name | Mrs. SARASWATI BAGE | Contact No | |
| Address | CHATRA TELI PARA,BAIDYABATI(M,) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||