Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03439 | Date 07/02/2019 |
| Token No | SM/19-20/5886 05/07/2019 | Serial | 049 Last Visit: 10/07/2019 |
| Patient Name | Mrs. MOUMITA MAHANTI | Contact No | 9830740131 |
| Address | 24/A/1 CHATRA KUMER PARA | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||