Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05717 | Date 10/07/2019 |
| Token No | SM/19-20/6196 10/07/2019 | Serial | 064 Last Visit: 10/07/2019 |
| Patient Name | Mrs. KALPANA PAL | Contact No | 8621992626 |
| Address | JARASUTALA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||