Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05692 | Date 08/07/2019 |
| Token No | SM/19-20/6028 08/07/2019 | Serial | 001 Last Visit: 27/07/2019 |
| Patient Name | Mrs. SAIDAN BIBI | Contact No | 7890600731 |
| Address | PANCHU GOPAL BHADURI SARANII,TINBAZAR | Age | 33 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||